Claims Specialist

What's This Role Really Like? 

The primary objective of this position is to manage all aspects of Work Injury Compensation claims (WICA-Employee and WIC-PW). Resolving of claims within prescribed authority in the most effective, efficient way while delivering a customer-centric claims service.

Role And Responsibilities:

• Proactively Manage Claims

• Reviewing and analyzing policy coverage
• Ensure adequacy of reserve, conduct on time file review and resolution
• Evaluate and negotiate the resolution of claims ensuring cost effective outcome
• Identifying potential fraud, risk management and recovery
• Managing client’s expectation both internal and external
• Managing vendors’ service level and quality of work
• Taking responsibility for ad-hoc projects

Areas Of Responsibility

Claims Service

• Work within local and regional on operating processes and claim handling procedures to ensure that quality claim service is rendered to all customers in accordance with Chubb Claims Philosophy.
• Attend to claim enquiries and feedback, maintain positive relationship with all customers, brokers, service providers etc, 
• Use external resources in accordance with the CHUBB guidelines and philosophies. This includes the engagement of appropriate service providers where required and management of such providers and cases towards the timely and effective resolution of the matter.

Claims Quality

• Manage and handle claims to finality within designated Settlement Authority and Chubb Claims Management Guidelines, including timely action, appropriate investigation, regular case reviews and proper evaluation are taken in all claims.
• Ensure that loss reserves are set and maintained in accordance with Chubb guidelines, timely updates of claims data made into systems and correctness of systems and file records, 
• Comply with Chubb quality review program guidelines and ensure corrective action is complemented as necessary.
• Complete Reserve Reconciliation and Advocacy reviews in accordance with CHUBB guidelines.

Others

• Maximize recoveries from insurers, salvage dispositions, subrogation or other recovery proceedings through close monitoring. Ensure timely advices, relevant supporting documents and responses to enquiries are provided to coinsurers / reinsurers to settle their share promptly. 
• As required, assist in claims related projects including UAT etc, and other projects/assignments or tasks, as assigned. 
• To meet or exceed the expectations/objectives set on the individual’s and the Team’s yearly goal setting.

Education & Experience

Skills And Experience:

• Knowledge in WICA claims handling.
• Excellent communication and internal personal skills. Ability to effectively manage all internal and external stakeholders.

• Excellent Customer Service.

• Ability to organize work effectively and methodically. Highly adaptable to change in a fast-paced environment.
• Ability to support the team claim handlers as required.