Senior Claims Liaison at PPS

Minimum Requirements

Education: 

• Degree in Occupational Therapy or Physiotherapy or any other medical/health quality.

Experience: 

• 8+ years’ experience in the insurance industry.
• 5+ years’ experience in claims assessment including Income protection, Lump Sum Disability, and dread disease.
• Prior experience in Sales Support and Risk Management is advantageous.

Knowledge and Skills:

• Capable of critically evaluating data to derive meaningful, actionable insights.
• Demonstrate superior communication and presentation capabilities for audiences without a technical background.
• Must have excellent telephone etiquette.
• Good computer knowledge - MS Outlook, Excel and Word are necessary.
• Good report writing and presentation skills.
• Must have a mature, disciplined, and driven personality.
• Ability to work independently as well as being a good team-player with excellent interpersonal skills. 
• Deadline/target driven, with ability to work under pressure.
• Logical and analytical.

Duties and Responsibilities

Claims Processing and Resolution:

• Analyze claims data, identify trends, and provide recommendations for improving claims processing and resolution.
• Investigate, evaluate, and negotiate complex insurance claims in a timely and efficient manner.
• Liaise with policyholders, claimants, and other stakeholders to gather necessary information and documentation to process claims.
• Ensure compliance with company policies, procedures, and regulatory requirements.

Internal Arbitrator and Ombudsman:

• Act as an internal arbitrator and ombudsman to assist stakeholders (e.g., policyholders, agents, brokers) with claims-related queries and issues.
• Facilitate the resolution of disputes and complaints through mediation and negotiation.
• Provide guidance and recommendations to stakeholders to ensure fair and equitable claim outcomes.
• Maintain detailed records of all arbitration and ombudsman activities.

Stakeholder Liaison:

• Collaborate with various departments and stakeholders to ensure seamless communication and coordination in the claims process.
• Provide presentations on request.
• Contribute to the development of claims-related policies, procedures, and training materials.

Presentations and Quality Assurance:

• Analyze quality assurance data and provide recommendations to enhance the overall claims management system.
• Conduct regular quality assurance reviews of claims processes and documentation to identify areas for improvement.
• Prepare and deliver presentations to management, cross-functional teams, and other stakeholders on claims-related topics.
• Convey insights through both reports and visual presentations.
• Provide constructive feedback to claims manager/-claims team regarding matters arising. 

Knowledge Sharing and Champion:

• Regularly share key learnings, best practices, and process improvements with the claims team and other relevant departments.
• Participate in team meetings, training sessions, and cross-functional initiatives to promote knowledge sharing and continuous improvement.
• Stay up-to-date with industry trends, regulatory changes, and emerging claims management practices.
• Provide guidance and support to claims assessors. 
• Empower team members with transfer of knowledge, be the Claims Team SME.
• Ensure that own knowledge is kept abreast with industry & regulatory information and changes through various internal and external information sources. Regulations to provide informed and up-to-date support.
• Provide technical information and support. Proactively identify opportunities to enhance claims processes and communication strategies.