Claim Manager

Job purpose: Assist the Head of Operations to oversee the performance of Claim Department (Claim Administration, Claim Assessment, Claim Investigation) in line with defined processes, standards and regulations to provide excellent services to customer & compliance with the company’s goals.

Key duties/Responsibilities:
- Manage Claim team in implementation of relating operations strategies, policies and processes;
- Problem Solving: Identifies, analyses, organizes and solves issues and reported problems in a timely and effective manner;
- Optimizes the business value delivered to the company while maintaining harmonious, professional relationships with internal and external customers;
- Leadership: Communicates a vision and motivates and leads other towards the achievement of goals and business objectives;
- Goal achievement: Adopts a strong orientation toward achievement; holds high expectations for oneself and others, pushes oneself and others to achieve a high level;
- Industry knowledge and Business acumen: Understands of core business principles and processes and keeps abreast of trends and developments in the insurance industry including competitors’ strategies, products and services;
- Develops and Empowers people: counsels and coaches others, providing direction, support and opportunities with foster their professional development;
- Claims handling: Investigated and settle claims in a fair, timely and economic manner; Assess appropriate settlement options to fulfil contractual obligation and company policies; Approve claims as per prescribed authority limits; Resolve complex claims and/or develop recommended solutions based on good judgment, initiative and technical skills as Claim Committee member;
- Understanding different types of claims: Demonstrates knowledge of the different types of claims and appropriate settlement procedures with sound knowledge of specific medical areas; effectively applies medical underwriting information;
- Product knowledge: Demonstrates knowledge of the key features and benefits of products in organization and applies this information to gain competitive advantage;
- Reinsurance Administration: Demonstrates practical knowledge and application of reinsurance and underwriting principle; co-operates with relevant department to review reinsurance treaties periodically to seek better solutions;
- Build and maintain excellent relationship with hospital, clinic networks and government offices, managing the Hospital/clinic and TPA/partner networks to provide excellent and effective service to customers in Individual Life Business. Maintain good relationship with other Departments such as CS, Underwriting, IT, Distribution... etc. to smoothly solve all claims-related issues and reach claims objectives;
- Monitor plan and KPI performance that deliver reduced relating unit and overall costs and process improvement on an ongoing basis, enhance KPIs via process improvement, team restructuring and better communication (local & regional level);
- Monitor and control the Claim functional operations to ensure appropriate controls are being implemented within the team; implement and review departmental First Line of Defense (FLOD) reports to ensure quality assurance;
- Communicate and coordinate with other departments in identifying improvement opportunities through customer feedback and implement action plans to minimize complaints;
- Prepare regular/ad hoc reports to senior management to highlight any trends, impacts and consequences observed;
- Perform other related duties as assigned/required.

Qualifications/Education:
- University Degree in Medical with medical background in Insurance is priority;
- Proficient in both English and Vietnamese;
- Preferably with LOMA qualification (FLMI/FLHC/ALU/CII).

Working experiences:
- At least 05 years of experience in Claim/Financial services at managerial level;
- Advance knowledge of insurance products and insurance operations;
- Knowledge of policy management/life insurance application.

Competencies:
- Excellent interpersonal and leadership skills with visionary traits;
- Ability to communicate a vision and lead, guide, motivate team members towards the achievement of goals, business objectives and service standards;
- Good initiative and drive to constantly review and enhance workflows of section to maximize operational effectiveness;
- Meticulous, organized and able to work under tight deadline and pressure;
- Customer service oriented & Good knowledge of MS Office applications;
- Ability to process requests with accuracy and deliver within service standards;
- Willing to take on additional responsibilities/task when assigned.

- Thu nhập cạnh tranh dựa theo kết quả kinh doanh; Chế độ bảo hiểm cho gia đình; Nghỉ phép 14 ngày
- Cơ hội đào tạo: đào tạo chuyên nghiệp liên tục
- Văn hóa làm việc: đánh giá cao sự năng động, linh hoạt, tinh thần đồng đội và lành mạnh

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