Claim Assessor, Senior Officer

1. Claims Assessment & Decision Making 

• Evaluate both major and minor claims. 

• Review claim documents and request additional info as needed 

• Identify and handle non-disclosure, misrepresentation, or fraud cases 

• Liaise with Reinsurance for concurrence 

• Make decisions within authority limits 

• Work with TPA and partners to ensure SLA adherence 

• Build and improve Claim process to have better service to customer but still control fraud condition 

2. Investigation & Fraud Control  

• Assign and review investigation tasks 

• Identify fraud indicators (Red Flags) in both minor and major Claims (e.g., fake invoices, split claims, non-disclosure, staged accidents). 

• Support audit and compliance reviews 

3. Process and System Development & Optimization 

• Contribute to claims process enhancement 

• Ensure compliance with internal control and regulations 

• Participate in system improvement projects (Requirement gathering, UAT)  

• Monitor claim data integrity to support accurate reporting and actuarial analysis. 

4. Customer & Complaint Handling 

• Handle Claims Complain to resolve case and avoid affecting the company's reputation. 

• Handle inquiries and complaints professionally 

• Communicate clearly with customers 

5. Coach/Mentor new Officers. 

6. Other tasks as requirement from OP director/ Manager  

University degree. Medical background (Doctor/Pharmacist/Nurse) is highly preferred. Alternatively: Insurance, Law, Finance.

Minimum 3 years in life insurance claims as assessor to handle major and minor claims

LOMA/ALMI/FLMI would be preferred

Good English reading and writing skills.