You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

Major Accountabilities:

1. Appraises all types and level of claims. May refer highly ambiguous claims to one or more of the following particularly for potentially contentious denials:  the Chief Administration Officer, Legal, Underwriting, Medical.  May also consult with Sales on group claims with account management implications.

2. Establishes claim policy & guidelines.  Defines and sets standards of accuracy, timeliness and productivity, and develops strategies and plans to meet these standards.  Reviews and revises claims guidelines to ensure that they are appropriate to market, legal and regulatory environments, and product design.

3. Determines, obtains and allocates resources required to meet objectives, including budget, personnel, etc

4. Manages the performance of Claims Manager and Claims Supervisor.  Develops management and claims appraisal capabilities.  Regularly reviews career development profiles, claim approval limits and training programs to ensure that the function keeps up with market and business requirements.

5. Determines and implements projects for the streamlining of operations or improvement of servicing capabilities

6. Determines what types of seminars to conduct, based on an analysis of agent and market needs, and directs the design of these seminars.

Core Professional/Technical Competencies Required

Abilities:

Assess major/critical legal and industry issues on claims with high ambiguity and exposures to the companyCalculate claims benefitsApply complicated theory and fundamentals of claims appraisalApply Insurance Code, Family Code, Civil Code & Rules of Court and any bodies of law in variety of complicated claims scenarios

Knowledge:

In-depth knowledge of insurance concepts, principles and terminologyIn-depth knowledge of claims concepts, principles and proceduresIn-depth knowledge of legal issues related to claims (general and local laws)In-depth knowledge of medical terminology and informationIn-depth knowledge of products offered by Sun Life FinancialIn-depth knowledge of customer service concepts and principlesIn-depth knowledge of underwriting concepts, principles and general proceduresIn-depth knowledge of management principlesIn-depth knowledge of procedures for responding to customer complaints about claimsIn-depth understanding of Sun Life Financial’s claim philosophyIn-depth understanding of Sun Life Financial’s standard of ethicsACS designationALHC designationFLHC designationFLMI designation

Core Soft/Transferable Competencies

Collaborates effectively                             :  ExpertCommunicates confidently                        :  ExpertFocuses on the customer                            :  ExpertTakes accountability                                   : ExpertUnderstands the business                            : ExpertAttracts, develops & retains talent              : ExpertBuilds & applies self-insight                       : ExpertDrives for action                                          : ExpertEmbraces differences                                   : ExpertGenerates innovative solutions                    : ExpertLeads change                                                : ExpertManages complexity                                    : ExpertThinks & acts strategically                           : ExpertPresentation Skills                                        : ExpertNegotiation Skills                                         : Expert

Development/Training to support Role Competencies

Relevant Courses-Professional/Technical Competencies

Asia Leadership Program

Management Effectiveness Program

LOMA 351 - Financial Services Environment

LOMA 356  - Investment Principles and Institutional Investing

LOMA 361 – Insurance Company Accounting

AIRC 410 - Regulatory compliance: Companies, Producers, and Operations

Professional, Customer Service (PCS) designation

Fellow, Life Management Institute (FLMI) designation

Fellow, Life and Health Claims (FLHC) designation

Education and Experience:

Minimum typical education

University degree with major in Business, Accounting or other related disciplines

Minimum typical experience

15 years of which 8 years are at managerial positions; expert level in life/insurance claims and in managing large team of people within large organization environment

Job Category:

Claims - Life & Disability

Posting End Date:

30/12/2024