Policy Admin
EMA Global
Date: 2 weeks ago
City: Petaling Jaya
Contract type: Full time
Job Summary: To manage all aspects of policy benefits inquiry, endorsements, and supporting claims operations. To drive best practices in handling policy inquiry benefits, endorsements, and supporting claims in terms of optimal outcomes in serving customers in the technical and professional aspects. To become the key escalation point within the organization.
Roles and Responsibilities:-
Roles and Responsibilities:-
- Assists customers in benefits inquiries, claims, and policy endorsement within the guidelines of respective insurance products.
- Time and accurately processing endorsements with efficiency and liaising with customers on the outcome of the endorsement, cancellation, additional premium, and refund.
- Act as Claims support in analyzing and refining their queries to accurately fulfill claims requests.
- Managing key claims handling inquiry; coverage determination and liability assessment for hospital claims, where appropriate within authority limits and providing a consistently strong standard of customer service.
- Ensuring effective management of claims within a personal allocation.
- Broader internal/external stakeholder communication where required
- Continuous improvement on claim file handling with feedback and support of the operations as well as finance processes.
- Providing timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact with all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
- Contribute to maintaining best-practice procedures for claims adjudication consistent with global best practices or within the standard guidelines of respective client’s requirements.
- Demonstrate basic competence and fraud detection analytic skills.
- Demonstrate a strong standard of competence in handling and resolving claims within the standard service level of claims handling.
- Attention to Detail:
- Ensuring accuracy in processing policy documents, maintaining records, and handling policy-related data.
- Communication Skills:
- Clear verbal and written communication with internal teams, policyholders, and external stakeholders.
- Ability to explain policy details, terms, and updates in a simple, understandable manner.
- Customer Service Skills:
- Ability to address policyholder concerns, inquiries, and requests professionally and empathetically.
- Problem-Solving Abilities:
- Capable of resolving discrepancies, finding solutions to policy-related issues, and addressing customer concerns quickly.
- Data Entry and Management:
- Proficiency in entering and updating policy information accurately in databases or CRM systems.
- Managing policy documentation and tracking policy changes.
- Compliance and Regulatory Knowledge:
- Understanding of industry regulations, compliance standards, and company policies to ensure that all processes adhere to legal and regulatory guidelines.
- Teamwork and Collaboration:
- Ability to work closely with other departments such as underwriting, claims, and sales to ensure smooth policy administration.
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