life claims OfficerAXA

Adjudicates and approves claim that fall outside Level 1's authority limits, cases that require special handling, or claims submitted for and/or by VIP customers as defined in the Life Claims Business Guidelines
Supports in the management of workload when other Claims Officers are out, including claim handling and servicing requestsAdjudicates and approves Death, Critical Illness, Daily Hospitalization Income, Accident Medical Expense reimbursement, Premium, Accidental Death & Disability, Permanent Total Disability, and Terminal Illness Benefit claims from the retail (individual) and/or group lines of business within your delegated authority limits and stipulated turnaround timeAssist Claim Officers, as needed, in conveying the relevant claim terms and conditions with properly identified claimants and/or distributors, via email or a virtual meeting, when encountering objections to the process of obtaining supporting documentsReviews and analyzes insurance policies, product technical notes, medical records, and other documentation to determine whether the claim is approved, denied, or needs additional documents.Complies with set policies and procedures in the identification of and prevention of losses due to fraudulent claimsAssesses the precise payable amount for the claim benefit (work) type after determining the applicable deductions or additions, if any, using the computing tools provided by AXA PhilippinesProvides complete, accurate, and timely responses to all properly identified distributors, Policy Owners, and/or Beneficiaries correspondence via written, chat, and/or e-mail channels regarding claim status, clarification on the required document, or settlement optionsCommunicates and coordinates with the Legal Department for guidance on cases that require special handling to ensure compliance with the applicable laws of the land and the Insurance Code of the PhilippineQualificationsYou are an excellent and effective communicator in English and Filipino in both written and verbal forms. You communicate in a pleasant and professional manner.You are detail-oriented and analytical. You can draw sound judgment and take a decision on the facts being presented in the claim documentation available to you without missing the important details in the documentation.You are a self-driven, motivated individual who shares a commitment to delivering exceptional customer service and provide timely resolution on complex cases.
AXA

Philippines
Permanent
Full-time