[OP] Senior Claims Assessor

Perform the role of a Claims Assessor responsible for evaluating, analyzing, and making fair and timely claim decisions in accordance with MB Life’s Terms & Conditions, internal guidelines, and regulatory requirements. Support investigation activities, coordinate with stakeholders, and contribute to the continuous improvement of claims service quality.
1, Claims Assessment & Decision Making

Identify and handle non- disclosure, misrepresentation, or fraud cases
Make decisions within authority limits
Review claim documents and request additional info as needed
Evaluate both major and minor claims (Death, TPD, CI, WOP, PPD, AHI, HSCR, etc.)
Build and improve the Claim process to have better service to customers, but still control the fraudulent condition
Liaise with Reinsurance for concurrence

2, Investigation & Coordination

Support audit and compliance reviews
Assign and review investigation tasks
Work with TPA and partners to ensure SLA adherence

3, Process Improvement & Compliance

Contribute to claims process enhancement
Ensure compliance with internal control and regulations
Participate in system improvement projects. Handle Claims Complaints to resolve cases and avoid affecting the company&039;s reputation. At the same time, pain points are defined to improve the service

4, Customer & Complaint Handling

Communicate clearly with customers
Support resolution of escalated cases
Handle inquiries and complaints professionally

5, Other tasks as required by the COO/ OP Director/ Manager

3, Certification: LOMA/ALMI/FLMI preferred
2, Experience: Minimum 3 years in life insurance claims as an assessor to handle major and minor claims
4, Language: Good English reading and writing skills.
1, Education: University degree in economics, finance, medicine, law, or equivalent
5, Others

Have a good teamwork spirit and can work independently
Understand the T&C, follow the processes to meet TAT and SLA, proactive evaluate customer requirements and make the right decisions, and communicate effectively with customers.
Customer- centric thinking.

Laptop, Chế độ bảo hiểm, Du Lịch, Phụ cấp, Du lịch nước ngoài, Đồng phục, Chế độ thưởng, Chăm sóc sức khỏe, Đào tạo, Tăng lương, Công tác phí, Nghỉ phép năm, CLB thể thao

Cập nhật gần nhất lúc: 2025-11-14 00:50:02