Head of Individual Claim & Investigation

• Coordinate, execute, and monitor Individual Claim operations, ensuring alignment with company directives.
• Verify completeness of Individual Claim submissions based on applicable regulations.
• Process the approval and request individual payments within approved SLAs and Terms & Conditions.
• Foster effective communication with stakeholders (Reinsurance, Business Partners, Medical Providers, and vendors) to uphold agreed-upon SLAs.
• Oversee the implementation of company claim regulations and ensure procedural completeness and discipline.
• Conduct comprehensive and timely analysis of customer claim data, providing accurate reports.
• Execute investigation processes, including field investigations, to ensure precise claim processing.

 Requirements:

• Minimum Bachelor's degree (S1) in Medicine /Ners from a reputable university.
• Minimum 5 years in Operations in the Life Insurance/General/Third Party Administration industry with min. 3 years in Managerial Role handling Individual Claim function or as an Investigator.