PASSAPP TECHNOLGIES CO.LTD

Claims Specialist

Generalបានបង្ហោះ 4 d ago

Location

Tuol Kouk | Phnom Penh

Job Type

FULLTIME

Experience

2+ Years

Experience level

កម្រិតសហការី

Work Mode

On-site

Industry

ទីផ្សារទុន និងទីផ្សារមូលបត្រ

Languages

Khmer, English

អំពីតួនាទី និងភារកិច្ច

Receive and register claim notifications from drivers, passengers, or beneficiaries; verify claim eligibility against trip data, policy coverage, and the group policy.
Cross-check claim details to confirm the incident occurred within a covered trip; review supporting documents for completeness, consistency, and authenticity.
Assess claim merits against policy terms and the TPD/PPD benefit table, calculate benefit amounts and any applicable deductions, and recommend approval, decline, or repudiation within delegated authority limits, escalating complex or high-value cases to the Head of Operations.
Identify and investigate contestable, early, large, or suspicious claims, coordinating with partners, medical officers, or external investigators, and escalating potential fraud or misrepresentation.
Communicate claim decisions clearly and empathetically to claimants and beneficiaries; manage related inquiries, complaints, and appeals.
Process and record claims in the system, maintaining accurate claim files, benefit calculations, and audit trails.
Ensure all claims are processed within IRC-mandated and internal turnaround times, maintain documentation to support IRC claims reporting, and flag AML/CFT-related concerns.
Prepare claims experience reports for management review, and recommend product or process improvements based on observed claims trends.

លក្ខខណ្ឌតម្រូវការងារ

Bachelor’s degree in Finance, Administration, Law, or a related field.
2+ years of experience in life/group insurance claims processing, accident or health claims, or a related insurance operations role; experience with embedded insurance, bancassurance, or digital/platform-distributed products is an advantage.
Professional insurance qualification (e.g., LOMA – FLMI/ALMI) is preferred.
Strong analytical skills and sound, evidence-based decision-making, with high attention to detail.
Excellent communication and interpersonal skills, with empathy and a customer-centric approach.
High level of integrity and discretion in handling confidential and sensitive information.
Comfortable working within core insurance systems and MS Excel for claims tracking, calculation, and reporting.
Ability to work under pressure, manage multiple concurrent cases, and meet deadlines in a fast-moving startup environment.
Proficiency in Khmer and good working English.

ជំនាញចាំបាច់

FinanceAdministrationLawLife/Group Insurance Claims ProcessingAccident or Health ClaimsInsurance OperationsEmbedded InsuranceBancassuranceDigital/Platform-Distributed ProductsLOMA – FLMI/ALMIAnalytical SkillsEvidence-Based Decision-MakingAttention to DetailCommunicationInterpersonal SkillsEmpathyCustomer-Centric ApproachIntegrityDiscretionCore Insurance Systems

ព័ត៌មានលម្អិតអំពីប្រាក់បំណាច់

Bonus:performance bonus

អត្ថប្រយោជន៍ទទួលបាន

Rewards for over performance

អំពី PASSAPP TECHNOLGIES CO.LTD

ចូលមើលគេហទំព័រ

Industry

ទីផ្សារទុន និងទីផ្សារមូលបត្រ

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អំពីតួនាទី និងភារកិច្ច

Receive and register claim notifications from drivers, passengers, or beneficiaries; verify claim eligibility against trip data, policy coverage, and the group policy.
Cross-check claim details to confirm the incident occurred within a covered trip; review supporting documents for completeness, consistency, and authenticity.
Assess claim merits against policy terms and the TPD/PPD benefit table, calculate benefit amounts and any applicable deductions, and recommend approval, decline, or repudiation within delegated authority limits, escalating complex or high-value cases to the Head of Operations.
Identify and investigate contestable, early, large, or suspicious claims, coordinating with partners, medical officers, or external investigators, and escalating potential fraud or misrepresentation.
Communicate claim decisions clearly and empathetically to claimants and beneficiaries; manage related inquiries, complaints, and appeals.
Process and record claims in the system, maintaining accurate claim files, benefit calculations, and audit trails.
Ensure all claims are processed within IRC-mandated and internal turnaround times, maintain documentation to support IRC claims reporting, and flag AML/CFT-related concerns.
Prepare claims experience reports for management review, and recommend product or process improvements based on observed claims trends.

លក្ខខណ្ឌតម្រូវការងារ

Bachelor’s degree in Finance, Administration, Law, or a related field.
2+ years of experience in life/group insurance claims processing, accident or health claims, or a related insurance operations role; experience with embedded insurance, bancassurance, or digital/platform-distributed products is an advantage.
Professional insurance qualification (e.g., LOMA – FLMI/ALMI) is preferred.
Strong analytical skills and sound, evidence-based decision-making, with high attention to detail.
Excellent communication and interpersonal skills, with empathy and a customer-centric approach.
High level of integrity and discretion in handling confidential and sensitive information.
Comfortable working within core insurance systems and MS Excel for claims tracking, calculation, and reporting.
Ability to work under pressure, manage multiple concurrent cases, and meet deadlines in a fast-moving startup environment.
Proficiency in Khmer and good working English.