PURPOSE OF THE ROLE
Process claims transactions within the required benchmarks and authority limit, communicate claims decisions in a clear and simple manner, provide claims handling service to clients, health service providers and intermediaries.
Provide administration support to Individual Life claims team.
Perform and support in user acceptance testing (UAT) for new system changes to ensure claims scenarios are duly covered.
Support and provide training to intermediaries or customers on claims processes or policy coverage.
Provide claims statistics reporting.
Compile with regulatory and risk management controls, corporate policies, procedure and claims guidelines.
To meet and resolve customer and intermediaries’ complaints, collaboration with Distribution, Service Relations and other departments in order to achieve customer satisfaction with fair outcomes as per the complaint resolution process.
Prompt delivery of given tasks and duties when assigned to adhoc project and initiatives.
Settling claims promptly, accurately and fairly.
Independent and strong leadership.
Timeliness in reports preparation and completion of assigned tasks.
Ensure proper work discipline
Ensure that risks taken in own areas of work are controlled within approved limits
Handling complaints effectively and timely
Effective Risk Management/Governance
Ensure all claims documentation and procedures adhere to company and claims management requirements
Ensure key risks have been understood, identified and managed and/that, where concerns or doubts exist, are raised with line management.
Ensure appropriate use of data intermediaries and other third party vendors, as well as for transfers of personal data outside of Singapore, including ensuring that adequate contractual safeguards are put in place, and/or appropriate consents has been obtained.
Responsible for compliance with applicable laws and regulations (including personal regulatory accountabilities in relation to fitness and propriety), and relevant Aviva’s Business Standards.
Ensure that employees receive adequate training to fulfil their compliance obligations.
Ensure that new regulatory requirements impacting the department/function are implemented, and an effective process is in place for regulatory consultations to be reviewed and analysed by subject matter experts.
Undertake regular self-assessments of the effectiveness of controls using tools such as regulatory obligations mapping to confirm compliance.
Ensure that potential control gaps, failures or breaches that could or have already resulted in a regulatory breach are escalated in accordance with issued guidelines.
Ensure that potential control gaps, failures or breaches that could or have already resulted in a regulatory breach are escalated to line management in accordance with issued guidelines.
Support Line Management to ensure that current and planned business operations are within BU’s risk appetite.
Fair Dealing Outcomes
Ensure full understanding of Fair Dealing Outcomes and one’s own accountability in delivering these outcomes as applicable to the role.
Total no.of colleagues reporting to the same manager: 6
RELATIONSHIPS (INTERNAL & EXTERNAL)
Business, Underwriting and Policy Servicing and System Support Units to ensure appropriate claims handling.
Doctors, Diagnostic Centers, Hospitals, and Third Party Administrators to provide cost effective and quality cares.
Clients, Intermediaries, Solicitors, CPF Board, MOH and reinsurers to ensure proper claim document submission and payments.
Insurance professional qualifications preferred
Reasonable to good communication and written skills
Good team worker and service-oriented
Results-focused personality is essential
Proficiency in computer applications – Microsoft office
5-6 years of relevant experience