SeaMoney - Claims Operation Specialist (Insurance) Experienced (Individual Contributor) Philipp

2 weeks ago

Manila, National Capital Region, Philippines Shopee Full time

The SeaMoney team enables and drives innovation by providing a range of financial products and services, including its mobile wallet, ShopeePay, to both individuals and SMEs. Its mission is to better the lives of individuals and businesses in the region with financial services through technology. SeaMoney is a part of Sea Limited, a leading global consumer internet company. In addition to SeaMoney, Sea's other core businesses include leading e-commerce platform, Shopee and digital entertainment arm, Garena.

Job Description:
  • Conduct daily claims team functions in coordination with local and regional teams
  • Help develop claims standard operating procedures, focusing on claims processing, investigation, dispute resolution, payouts, and reporting
  • Oversee complicated claims cases on an as-needed basis with input from underwriting and business teams as well as reinsurers, as applicable.
  • Aid in creation of claims financial standards and KPIs and develop / monitor claims metrics to manage portfolio loss ratio and claims processing benchmarks
  • Engage in fraud prevention analysis and develop investigative guidelines to serve as standard for claims risk management
  • Coordinate with the Product Management Team to drive and manage system enhancements for claims process and overall insurance products
  • Support quality assurance and user acceptance testing (UAT) efforts working with relevant stakeholders to ensure alignment with system and customer requirements
  • Work alongside business and cross-functional teams to constantly optimize the operational processes and product experience of the internal and external users
Requirements:
  • A Bachelor's Degree in Finance, Commerce, Accounting or Business equivalent
  • Minimum of [5] years of experience in a Life Insurance firm. Experience with general and health insurance products is preferred
  • Good understanding of local life and health insurance product market, including main claims processes and main technology tools used to manage claims in a large-scale insurance setting
  • Understanding of health-related claims and overall Filipino health service systems (i.e. public / private healthcare, clinics, other providers) network
  • Good understanding of local regulatory requirements, particularly from a claims perspective
  • Experience working with cross-functional, multi-country teams; able to work with internal and external stakeholders well
  • Ability to identify, analyze and solve problems as well as the ability to learn rapidly, adapt quickly to change, exercise influence, and manage and prioritize multiple concurrent projects
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