Claims Executive (Insurance)
Intelek Staffing Services Sdn. Bhd. Kuala Lumpur Full-time
Adjudicate Accident & Health (A&H) claims and deliver fair, accurate, and timely claims decisions within service level standards.
- Ensure compliance with regulatory requirements, internal guidelines, policy terms, and reinsurance agreements.
- Conduct thorough claims investigations by liaising with claimants, financial consultants, medical providers, and insurers.
- Follow up on outstanding documents and maintain proper documentation while providing regular status updates.
- Collaborate with internal departments to ensure claims are processed efficiently and accurately in line with SLAs.
- Handle customer enquiries, disputes, and appeals professionally and effectively.
- Support system improvements and projects by translating business needs into test cases and performing user acceptance testing (UAT).
- Degree in Biology, Life Sciences, or any related field
- Minimum 1-2 years of experience in Life & Health claims
- Familiarity with medical terminology, diseases, and treatments
- Strong communication skills in English (spoken & written)
- Proficient in basic Mandarin is an added advantage
- Ability to work independently
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Requirements:
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Job Description
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