Claims Assessment_Critical Illness, Analyst

2 weeks ago

Ho Chi Minh City, Ho Chi Minh, Vietnam AIA Australia Full time ₫1,500,000 - ₫3,000,000 per year

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

We are looking for Claims Assessment_Critical Illness, Analyst

Report to: Manager, Claim Assessment – Critical Illness

Location: Ho Chi Minh

Function: Customer & Information Technology | Department: Customer Office

Type: Individual Contributor

THE OPPORTUNITY:

  • Perform claims assessment and decision-making for Critical Illness claims within assigned authority level.
  • Handle customer complaints related to claim decisions and support resolution for escalated cases.
  • Participate in system enhancement initiatives and ensure compliance with claim procedures and regulations.

ROLES AND RESPONSIBILITIES:

1.Claims Assessment & Decision

  • Assess and make decisions on Critical Illness claims within Authority Level B.
  • Ensure claim decisions are accurate, fair, and aligned with policy terms and internal guidelines.

  • Propose solutions for cases exceeding authority level and escalate appropriately.

  • Customer Complaint Handling

  • Handle customer complaints related to claim decisions with professionalism and empathy.

  • Coordinate with internal teams to investigate and resolve issues.

  • Provide clear explanations and ensure timely resolution to maintain customer satisfaction.

  • System & Process Support

  • Participate as a project member in testing new system features and enhancements.

  • Learn and update knowledge on claim systems, procedures, and administration processes.

  • Ensure compliance with updated claim regulations and procedures.

  • Stakeholder Coordination

  • Coordinate with internal departments to process claim cases efficiently.

  • Communicate with external parties (e.g., TPAs) to provide or clarify claim-related information.
  • Ensure all communications follow company regulations and procedures.

JOB REQUIREMENTS:

  • College or University Degree; Medical or Law degree preferred
  • LOMA 280 & 290 certifications will be a plus
  • Minimum 2–3 years of experience in claims processing
  • Practical knowledge of insurance and claim procedures
  • Ability to assess claims and interpret medical/legal documents
  • Familiarity with claim systems and digital tools
  • Strong communication and customer service skills
  • Adaptability and problem-solving mindset
  • Team collaboration and responsiveness
  • Development opportunities: grow into senior roles & exposure to system development and cross-functional projects

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.

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