Claims Management Associate / Analyst
Accenture · Selangor, Malaysia · 1d ago
Job Summary
The primary purpose of the job is to handle inbound and outbound calls from Insurance Agents and Customers to answer questions/ or attend to requests on but not limited to claim, policy inquiries, and handling complaints and irate customers etc. During call handling, he/she is required to check status of claims, review policy benefits and advise customers accordingly.
Apart from voice work, he/she will also be required to register and adjudicate claims which involve investigation, evaluation, negotiation and settlement. This is done by collecting and analyzing data according to policy application and/or contract provisions. Determine whether to accept or deny a claim based on all documentation received. Typical claims include liability and low complexity coverage issue disputes.
Job Descriptions:
Utilize advanced communication, comprehension and customer service skills to handle Customer/Agent requests and inquiries.
Utilize acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records. May require additional contact with other parties i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc. as deemed necessary
Ensure proper follow up on cases to resolve outstanding issues and to ensure timely processing and closure of claim
Provide timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, responding to incoming inquires according to company policies, following agreed internal and external processes, policies and procedures to ensure quality and service standards are met. This includes all forms of communications to internal and external parties
Maintain accurate system data and documentation by collecting, recording, analyzing, and summarizing information
Ensure that reserves are accurately updated in a timely manner
Identify subrogation opportunities and fraud potential and make appropriate referrals
Provide mentorship to less tenured examiners
Deputy/Backup Team Leader for all matters pertaining to operational governance, practice and execution in the team. Advocate of process & people management, operational excellence, metrics & management information, risk & compliance
#LI-GM
Job Requirement/Qualifications:
Certified in Singapore College of Insurance - General Insurance and/or Health Insurance and/or Professional Qualification in Malaysian Insurance Institute - Certificate of Insurance Practice/Diploma in Insurance/AMII/FMII
Ability to prioritize and multitask effectively in a fast-paced environment
Good relationship building skills (internal, external, and cross - cultural)
Ability to communicate information clearly and concisely both verbally and in writing
Requires proficiency in Desk Management, phone ‘etiquette’, time management and dealing with difficult customers
Advance skills and experience in field of Customer Service (required) and/or Personal Accident Claims Processing (advantage)
Communication skills and interpersonal skills will be an advantage
Ability to document work in progress in accordance with applicable procedures will be an advantage
Working Hours: Monday - Friday 8.30 AM - 5.30 PM
About Accenture
Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities.Visit us atwww.accenture.com
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