Senior Associate-Claims

Reposted One Month Ago
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Hiring Remotely in Cyberjaya, Sepang, Selangor, MYS
Remote
Senior level
Insurance • Financial Services
The Role
Assess, validate and authorize individual health insurance claims for corporate policies. Process claims end-to-end, analyze medical documentation, resolve payment discrepancies, escalate suspected fraud, correspond with stakeholders, and support operational resilience and process improvements.
Summary Generated by Built In

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Sound like you? Then read on.

About the Role

Responsible for determining the validity and authorising settlement of individual health insurance claims for AIA Singapore Corporate Solution policies.

  • Process Corporate Solutions claims including registration, assessment, payment processing and letter preparation to meet department requirements & benchmarks.

  • Independently assess complex claims by applying strong technical judgment, policy interpretation, and medical understanding to ensure fair and accurate claim outcomes.

  • Analyze medical reports, invoices, and supporting documentation to validate claim eligibility, identify inconsistencies, and determine appropriate claim decisions in line with policy terms and exclusions.

  • Identify, investigate, and escalate potential fraud, abuse, or leakage risks, working closely with the Fraud Investigation Unit and relevant stakeholders to support effective risk mitigation.

  • Manage claims requiring additional information by preparing clear, professional, and compliant correspondence to claimants, healthcare providers, and third parties, ensuring timely follow‑ups and resolution.

  • Resolve payment discrepancies and suspense items through coordination with Finance, customers, and internal teams to ensure accurate and timely settlement.

  • Collaborate effectively with internal and external stakeholders (e.g. business partners, hospitals, service providers) to resolve escalations and support positive customer outcomes.

  • Perform additional duties as required to support operational resilience, service continuity, and evolving business needs.

Requirements

  • Minimum 2 years of relevant experience in handling minor medical claims.

  • Medical Lab Technologists / Scientists with 2-3 years of experience are also welcomed to apply.

  • Strong technical knowledge of claims assessment, including policy interpretation, exclusions, medical terminology, and dispute resolution, with consistent application of judgment and controls.

  • Analytical mindset with the ability to interpret data, trends, and exception indicators, including fraud flags, anomaly alerts, and quality findings to support sound, risk‑based decision‑making.

  • Strong problem‑solving and critical‑thinking skills, particularly in handling exceptions, escalations and non‑straight‑through processing cases.

  • High level of attention to detail and follow‑through, ensuring completeness, accuracy, and timely closure of claims and related correspondence.

  • Effective communication skills, both written and verbal, with the ability to explain claim decisions clearly and professionally to internal and external stakeholders through digital channels.

  • Willingness and ability to adapt to change, including adoption of new systems, automation, analytics tools, and evolving claims practices.

  • Demonstrate commitment to continuous learning, skill development and participation in process improvement initiatives.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

Skills Required

  • Minimum 2 years of relevant experience in handling minor medical claims
  • Medical Lab Technologist or Scientist with 2-3 years' experience
  • Strong technical knowledge of claims assessment, policy interpretation, exclusions, medical terminology, and dispute resolution
  • Analytical mindset able to interpret data, trends, fraud flags, anomaly alerts, and quality findings
  • Strong problem-solving and critical-thinking skills for exceptions, escalations, and non-straight-through cases
  • High attention to detail and follow-through to ensure accurate, complete, and timely claim closure
  • Effective written and verbal communication skills to explain claim decisions to stakeholders via digital channels
  • Willingness and ability to adapt to new systems, automation, and analytics tools
  • Commitment to continuous learning, skill development, and participation in process improvement initiatives
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The Company
HQ: Hong Kong
25,938 Employees
Year Founded: 1919

What We Do

AIA Group Limited is a multinational insurance and financial services corporation headquartered in Hong Kong, providing life insurance, savings, and health protection products across the Asia-Pacific region.

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