Claims Assessment, Analyst_Critical Illness

Location: Ho Chi Minh
Type: Individual Contributor
Report to: Manager, Claim Assessment – Critical Illness
Function: Customer & Information Technology | Department: Customer Office
THE OPPORTUNITY:
• Handle customer complaints related to claim decisions and support resolution for escalated cases.
• Perform claims assessment and decision- making for Critical Illness claims within assigned authority level.
• Participate in system enhancement initiatives and ensure compliance with claim procedures and regulations.
ROLES AND RESPONSIBILITIES:
Claims Assessment & Decision
• Ensure claim decisions are accurate, fair, and aligned with policy terms and internal guidelines.
• Propose solutions for cases exceeding authority level and escalate appropriately.
• Assess and make decisions on Critical Illness claims within Authority Level B.
Customer Complaint Handling
• Handle customer complaints related to claim decisions with professionalism and empathy.
• Coordinate with internal teams to investigate and resolve issues.
• Provide clear explanations and ensure timely resolution to maintain customer satisfaction.
System & Process Support
• Learn and update knowledge on claim systems, procedures, and administration processes.
• Ensure compliance with updated claim regulations and procedures.
• Participate as a project member in testing new system features and enhancements.
Stakeholder Coordination
• Ensure all communications follow company regulations and procedures.
• Coordinate with internal departments to process claim cases efficiently.
• Communicate with external parties (e.g., TPAs) to provide or clarify claim- related information.

• Annual leave and Company extra leave days• Social- Medical- Unemployment Insurances• Healthcare for you and your family• Annual medical check- up• Company outing• Flexible benefits• Others
• 13th month bonus• Performance bonus

Cập nhật gần nhất lúc: 2025-10-23 18:35:02