Senior Executive (Healthcare - Claims)

KEY OUTPUTS:
- To handle all personal claim types including but not limited to Personal accident, Healthcare, Travel and miscellaneous claims under retail and digital channel. The work base is in Hanoi or HCMC but he/she would cover claims throughout the country.
- To support handling and administrative work related to claims service, E-claims portal and E-claims system.
- To comply with the Claims Manual, Authority Matrix and Guidelines.
- To set appropriate reserves within the authorized limit and report to the Managers as required;
- To follow up outstanding claims information and documents with claimants for settling claims;
- To keep a good communication with customers (internal and external) to achieve a greater customer satisfaction claims service;
- To observe accuracy, completeness and timeliness when carrying out daily responsibilities;
- To assist the Managers in preparing reports and statistics as required;
- To manage TPAs (third party agents) by conducting audit activity & report periodically to improve TPAs' quality service
- To outline Claims flow and prepare training program to TPAs relating to retail insurance projects via insur-tech and digital platforms.
- Contribute to the sales function of the Company:
• Be alert to identify sales opportunities in the course of handling claims, and drawing these to the attention of appropriate staff;
• Assist in handling claims in a way which will enhance the Company's image and reputation for services of high speed and efficiency;
• Keep abreast of development in all classes of insurance in the market in order to identify trends and to formulate and propose plans to safeguard the Company's competitive position;
• Ensure that cases beyond personal authority are preferred correctly with full supporting information and opinion and that the direction of higher authority is supported and implemented without delays;
• To execute other office tasks as required by the Company;
• To authorize claims payment under Senior executive authority limit as per Claims manual.