Subject Matter Expert

Role Purpose:

The primary purpose of this role is to produce a high-quality Claims work through prompt and professional contact with customers and brokers. Serve as the primary referral/escalation for any claims queries within the team consist of 10-12 examiners and other departments including In-country Stakeholders. Manage complex claims including decline claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia Pacific countries supported.

Serves as a process trainer as needed, side-by-side coach for new hire as they gain claims experience and develop speed. Performs in depth claims review for escalated claims by in-country and rectifies it if needed including calling the claimants directly. Contributes heavily in identifying process improvement opportunities to be more efficient and provide better service delivery. Personally manage claims end-to-end within the approved limits for this SME role, this includes claims referred by subordinates that they are not approved to handle, for declination and/or don't have the system limits to perform.

Key Responsibilities:

1. Serve as the primary point of contact for complex claims inquiries, providing expert guidance and support to team members and other departments.

• Manages the various claims mailbox to process complex and/or urgent requests from the team and in-country.

• Manage and investigate complex and escalated claims, including approval of possible decline through corresponding with Customers and providing updates or requesting additional information as needed.

• Investigate and evaluate complex claims applying technical knowledge in determining appropriate settlement amount in accordance to policy terms and conditions.

• Manage negotiation with Claimant and Brokers appropriate claims decision including denial and settlement amount.

• Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records.

• Prepares and sends written correspondences (e.g. Denial Letters, Request for further information, Settlement etc.) to brokers, claimants and others as required.

• Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc.

• Handles escalated calls including denial calls from Customers and/ or Brokers.

• Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.

• Engage team huddle and group discussion regarding product updates and teach back sessions with In-country.

• Conducts training to new hires including floor walk duties and mentoring new hires.

• Identify issues, process breakdowns and provide recommendations for process improvements.

• Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.

• Nominate, review and endorse process improvement ideas from the team to the TL and Manager.

• Conducts audits for new hire product training certification (HOT and LAMP) ensuring mastery of claims process and products.

• Participate in various claims projects and initiatives to enhance overall claims operations and service delivery.

• Performs User Acceptance testing on various system enhancements or roll outs.

• Serves as a back up to the Team Leader.

Experience:

• Excellent analytical skills and strong attention to detail.

• Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers.

• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.

• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.

• Ability to develop and implement appropriate claims management strategies and plans.

• Strong Investigation techniques.

• Sound knowledge of claims administration procedures and related systems.

• Possess strong customer service behaviour.

Qualifications:

• Tertiary Qualified or minimum 3-4 years similar work experience

• Claims Insurance background is required