Assistant Manager, PA Claims (Financial Institution) #JTL

1. Claims Assessment & Decision Making

• Assess and approve personal accident claims accurately within established turnaround
• times, in line with policy provisions and authority limits.
• Evaluate medical, financial and supporting claim documentation, ensuring appropriate
• claim decisions and reserve adequacy.
• Manage claim investigations, including clarification with medical institutions, policyholders,
• and internal stakeholders.
• Review of pending claims to ensure timely resolution and proper closure.
• Identify claim patterns and unusual or inappropriate practices and recommend
• improvements to strengthen claims controls and streamline claim processes.

1. Stakeholder & Customer Engagement

• Collaborate with medical institutions, policyholders, and internal stakeholders to gather
• and clarify clinical information or outstanding requirements.
• Deliver high standards of customer service and strengthen relationships with customers
• and distribution channels.

1. Delivery of Service Excellence

• Provide clear, empathetic communication timely to policyholders, claimants and agents
• medical professionals, and internal stakeholders, making the claims process smooth and
• transparent.

• Minimum Diploma or Degree in any discipline
• Preferably with 2 to 3 years of relevant claims administration experience from insurance industry

EA License No: 99C4599