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Full-time
bachelor degree, professional certificate
Posted 48d ago
~40 hrs/week
Responsibilities
Lead and manage the Critical Illness Claim team to ensure accurate, fair, and timely claim assessments. Drive operational excellence through data analytics, quality audits, and effective stakeholder communication.
Requirements
Requires a Bachelor's degree in Law or a Medical Doctor degree, along with LOMA certifications. Candidates must have 3-5 years of experience in Life Insurance Claims, including 3-4 years in a managerial role.
Full job description
FIND YOUR 'BETTER' AT AIA
We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us.
We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.
If you believe in better, we’d love to hear from you.
About the Role
About the Role
Report to: Head of Claims Location: AIA Office, Saigon Centre Tower 2, 67 Le Loi street, D.1, HCMC Function: Customer Office | Department: Claims Type: Manager
THE OPPORTUNITY: Lead and manage the Critical Illness Claim team to ensure accurate and timely claim assessment and decision-making within authorized limits, while driving operational excellence through data analytics, system and procedure management, and effective communication with customers and stakeholders.
ROLES AND RESPONSIBILITIES:
1. Claims Assessment
Set goals and objectives for the Critical Illness Claim team to achieve operational results in claim assessment, reporting, and stakeholder engagement.
Conduct claims assessment to ensure accurate and fair evaluation of Critical Illness claims.
Manage claim decisions within authority level D, ensuring fairness, accuracy, and timeliness.
Ensure compliance with claim policies, practices, and procedures across all team activities.
Collaborate cross-functionally to resolve complex claim issues and support strategic initiatives.
Collaborate Re-insurers to get their experiences for claim process.
2. Quality Assurance
Monitor and audit claim handling processes to maintain accuracy and efficiency, including conducting audits, providing feedback to staff, and implementing improvements.
Oversee system and procedure enhancements to improve claim processing efficiency.
3. Customer Service
Address inquiries and issues related to claims from healthcare providers, policyholders, and internal stakeholders by providing clear explanations and resolving disputes.
Communicate and negotiate effectively with internal and external stakeholders, including customers, medical providers, and legal entities.
Represent the Claims Department to share claim experiences with GADs and agents to ensure thorough understanding of claims procedures.
4. Data Analysis and Claims Efficiency
Utilize data analytics to monitor performance, identify trends, and support continuous improvement.
Analyze claims data to identify trends, patterns, and areas for improvement, helping to optimize claims processes, reduce errors, and detect/prevent fraud, abuse, and waste.
5. Team Management
Supervise and develop claim specialists, providing guidance, training, and performance management.
Lead a team of claims processors and coordinators, including training, mentoring, and ensuring staff have the necessary resources to perform their roles effectively.
Ensure claims are processed accurately, efficiently, and in compliance with regulations, contributing to the financial health and operational success of the organization.
Manage stakeholders’ expectations efficiently to balance company benefits and customer experiences.
Manage provider relationships to ensure smooth operations between the Health Claims team and providers, especially in direct billing scenarios.
6. Product Development
Collaborate with Product and Actuarial teams to contribute claim insights during product development, ensuring clear terms and conditions that enhance customer understanding and minimize claim losses.
JOB REQUIREMENTS:
Bachelor’s degree or higher in Law or Medical Doctor
LOMA certifications: 280, 290, 301, ACS
Minimum 3 – 5 years in Life Insurance Claims
At least 3 – 4 years in a managerial role
Advanced knowledge of Life Insurance and legal frameworks
Strong analytical and decision-making skills
Proficiency in claim systems and reporting tools
Leadership and team development
Agility and adaptability in a dynamic environment
Strong communication and negotiation skills
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.
AIA Group Limited and its subsidiaries (collectively “AIA” or the “Group”) comprise the largest independent publicly listed pan-Asian life insurance group. It has a presence in 18 markets – wholly-owned branches and subsidiaries in Mainland China, Hong Kong SAR(1), Thailand, Singapore, Malaysia, Australia, Cambodia, Indonesia, Myanmar, New Zealand, the Philippines, South Korea, Sri Lanka, Taiwan (China), Vietnam, Brunei and Macau SAR(2), and a 49 per cent joint venture in India. In addition, AIA has a 24.99 per cent shareholding in China Post Life Insurance Co., Ltd.
The business that is now AIA was first established in Shanghai more than a century ago in 1919. It is a market leader in Asia (ex-Japan) based on life insurance premiums and holds leading positions across the majority of its markets. It had total assets of US$345 billion as of 31 December 2025.
AIA meets the long-term savings and protection needs of individuals by offering a range of products and services including life insurance, accident and health insurance and savings plans. The Group also provides employee benefits, credit life and pension services to corporate clients. Through an extensive network of agents, partners and employees across Asia, AIA serves the holders of more than 44 million individual policies and over 16 million participating members of group insurance schemes.
AIA Group Limited is listed on the Main Board of The Stock Exchange of Hong Kong Limited under the stock codes “1299” for HKD counter and “81299” for RMB counter with American Depositary Receipts (Level 1) traded on the over-the-counter market under the ticker symbol “AAGIY”.
(1) Hong Kong SAR refers to the Hong Kong Special Administrative Region.
(2) Macau SAR refers to the Macau Special Administrative Region.
Offices: AIA Central, 1 Connaught Road, Central, Hong Kong N/A, HK
life insuranceretirement planningaccident and health insuranceand wealth management solutionsWealth ManagementInsuranceFinancial ServicesHealth Insurance