Job Description

In this position you will…

…drive smooth end-to-end daily operational activities as a Claims Agent, managing customer claims from first notification through assessment and resolution. Your focus will be on accurate claims processing, clear customer communication, and meeting service level agreements (SLAs) with first-class turnaround time (TAT). You will work with a strong team of seasoned professionals to execute best practices, continuously improve the claims process, and deliver a positive customer experience.

You will be responsible for…

• Managing claims (backend) by confirming coverage and policy information to achieve intended outcomes.
• Receiving and registering First Notification of Loss (FNOL), verifying claimant and policy details, and confirming coverage, eligibility, and exclusions based on policy terms.
• Reviewing, validating, and indexing claim documentation (e.g., claim forms, receipts/proof of ownership, incident details, photos) and proactively requesting missing or additional information to support assessment.
• Assessing claims against policy coverage and internal guidelines to determine appropriate outcomes (e.g., approve repair/replacement, negotiate settlement, or recommend decline) and escalating exceptions in accordance with authority limits.
• Maintaining accurate, timely updates in claims systems, including clear claim notes, document status, approvals, and required trackers to support audit readiness, reporting, and service governance.
• Communicating claim decisions and requirements to customers clearly and professionally, setting expectations on timelines, explaining next steps, and managing escalations/complaints to resolution.
• Identifying potential fraud indicators or inconsistencies, applying required controls, and referring cases for further investigation in line with internal processes and insurer requirements.
• Managing our service providers to move the claims towards a desirable direction.
• Building relationships with both internal and external customers and other stakeholders
• Managing daily claims status enquiries which includes 1st level escalation management in a composed manner.
• Ensuring confidentiality of all claims information, inclusive of claims insurance guidelines and internal control 
• Engaging with ARC (authorized repair centers) on quotation, RNF, invoices & parts availability for devices/home appliances that are sent for repair.
• Coordinating 3PL logistic & On Demand logistic partners on activities to full fill claims within specific TAT.
• Act as a Claims Agent point of contact by responding to calls, emails, and written enquiries, providing clear status updates and next steps to customers in line with operating procedures, turnaround time, and KPI.
• Conducting in-house investigation by taking recorded statements, documentation, reviewing repair estimates, securing relevant pictures and evidence, etc.
• Maintaining compliance with the local BNM & Insurer Practices Act or rules and internal instructions.

For you to be successful…

…we expect you to be able to demonstrate the following key competencies:

Curious

• Motivated and self-directed, identifying opportunities to grow and acquire new knowledge from a range of sources. Has a sound comprehension of relevant multi-discipline areas of expertise.
• Demonstrates reflection and solicits feedback from others. Evaluates and learns from setbacks and adversity.

Communication

• Effective and articulate communicator actively and respectfully listens to and synthesizes others’ perspectives.
• Concise in communicating and references relevant information tailored to the audience to support points.

Collaborative

• Inclusive, empathetic and encourages and facilitates other team members to unite and deliver positive results.
• Develops strategic relationships and networks across the organization and shares with others for mutual benefit.

Adaptable

• Is quick to adapt approach and act flexibly in response to changes in the strategic and/or operational direction of the organization.
• Modifies style and leverages different approaches depending on different situations and circumstances.

Job Requirements

You will require the following qualifications and skills

• Candidate must possess at least a Diploma or Professional Degree in any field with a minimum of 3 years’ experience in insurance claims handling.
• Knowledge of loss settlements and ability to negotiate settlement of claims in a timely and reasonable.
• Ability to learn and apply claim insurance policies and procedures. 
• Critical competencies include but are not limited to customer focus, attention to details, quality computer skills and adaptability.
• Good outsource vendor management skills.
• Must possess good command in written and spoken English and Malay.
• Must have a customer service background with strong verbal and written communication skills, including experience managing customer expectations throughout the insurance claims process.
• Must be able to work under pressure and manage tight timelines in a TAT- and KPI-driven environment, ensuring quality and accuracy are maintained.
• Must demonstrate strong teamwork and collaboration skills, working effectively with internal teams and external partners to achieve service outcomes.
• Strong and proven problem-solving skills.
• Ability to work on 7-day, office hours in a rotating shift and over-time if required.

Skills