Job Description :
Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Claims Manager.
Specific Accountabilities :
Appraises and approves death and living benefit claims within approval limits. Secures Underwriting, Legal and / or Medical input where necessary.
Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Claims Manager for review and approval.
Reviews and approves check request within CAS approval limits and initially reviews and submits to Claims Manager for approval those beyond CAS approval limits.
Attends to claim inquiries ranging from basic to complex in nature.
Represents Sun Life in mediation required by Insurance Commission and Court hearing, as required, involving cases appraised within approval limits.
Conducts learning sessions for Claims Services Section, as required.
Skills and Knowledge Required :
Graduate of any four-year course. A medical / allied medical science or legal background would be an advantage.
Very good analytical, judgment, comprehension and conceptual thinking skills
Detailed-oriented, organized, systematic.
Patient and interested to read and familiarize self with provisions of the law, medical materials and review and scrutinize various documents.
Can work independently and is decisive.
Can work ably under pressure and multi-task.
With strong customer service orientation and good sense of urgency.
Possesses effective interpersonal relationship skills and is a team player.
With above average written and verbal English communication skills.
Willing to study and pursue required LOMA and ICA courses under Claims Career Development Program.
With good attendance and punctuality record.
Job Category :
Claims - Life & Disability
Posting End Date : 26 / 09 / 2019
26 / 09 / 2019