Assistant Manager -Life Claims at Great Eastern Life Assurance Co Ltd

Cuenca, Azuay, Ecuador -

Full Time

Start Date

Immediate

Expiry Date

14 Jul, 26

Salary

0.0

Posted On

15 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims assessment, Medical terminology, Analytical skills, Decision making, Customer service, Stakeholder management, Regulatory compliance, Risk management, ICD codes, CPT codes, Insurance policy interpretation, Data analysis, Communication, Attention to detail, Conflict resolution

Industry

Insurance

Description

At Great Eastern, we’re redeﬁning what it means to be a claim professional. Join a passionate team where your medical knowledge, analytical skills, and attention to detail will directly impact the lives of our customers and the future of life insurance. You will be responsible for the accurate and timely assessment of life insurance claims, ensuring fair outcomes in accordance with policy terms, service standards, and regulatory requirements. You’ll also be empowered to contribute to service excellence initiatives that enhance the overall claims experience. It’s a career path that builds deep expertise in claims assessment and customer care. Claims Assessment & Decision Making Assess and approve life claims and appeals accurately within established turnaround times, in line with policy provisions and authority limits. Evaluate medical, financial and supporting claim documentation, ensuring appropriate claim decisions and reserve adequacy. Manage claim investigations and appeals, including clarification with medical institutions, policyholders, and internal stakeholders. Review of pending claims to ensure timely resolution and proper closure. Identify claim patterns and unusual or inappropriate practices and recommend improvements to strengthen claims controls and streamline claim processes. Stakeholder & Customer Engagement Collaborate with medical institutions, policyholders, and internal stakeholders to gather and clarify clinical information or outstanding requirements. Deliver high standards of customer service and strengthen relationships with customers and distribution channels. Delivery of Service Excellence Provide clear, empathetic communication timely to policyholders, claimants and agents medical professionals, and internal stakeholders, making the claims process smooth and transparent. Ensure Compliance Adhere to internal policies and external regulatory requirements to maintain integrity and trust in our claims operations. Take accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks. Maintain awareness of industry trends on regulatory compliance, emerging threats and appropriate steps to mitigate the risks. Highlight any potential concerns/risks and proactively shares best risk management practices. Holds a Bachelor’s degree or Professional Insurance Certiﬁcate or a related insurance or healthcare discipline 3–5 years of experience in relevant life and/or health claims experience Strong grasp of medical practices, terminology, ICD/CPT codes, and insurance policy terms Strong analytical skills with ability to interpret complex medical data, spot trends, and make sound decisions under pressure High attention to detail with strong decision-making discipline Detail-oriented with a proven track record of managing high processing volumes without compromising quality Are customer-focused and excellent at building relationships with stakeholders and delivering clear, empathetic communication Team players; are eager to learn and grow in a fast-paced, collaborative environment that values innovation and service excellence

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Responsibilities

The Assistant Manager is responsible for the accurate assessment and approval of life insurance claims while ensuring compliance with regulatory standards. They will also manage claim investigations, appeals, and collaborate with stakeholders to maintain high service excellence.