Non-Medical Claims, Consultant

About the Role

Process incontestable and contestable major claims (e.g., Critical Illness, Total and Permanent Disability, Dismemberment, Death claims).

Roles and Responsibilities

• Major Claims Processing: Handle and settle both incontestable and contestable major claims within the agreed turnaround time (TAT) and in compliance with established procedures and guidelines.
• Pending Case Management: Review all pending cases monthly and work towards reducing the pending ratio in line with agreed targets.
• OPAT Savings: Monitor closed file reviews and ensure timely provision reversals to achieve operational savings.
• Productivity & Accuracy: Meet claims productivity benchmarks within authority limits, delivering work with high accuracy and efficiency.
• Stakeholder Communication: Respond promptly to enquiries, calls, and emails from relevant stakeholders within two (2) business days.
• Suspense Case Management...