PASSAPP TECHNOLGIES CO.LTD

Claims Specialist

GeneralPosted 6 d ago

Location

Tuol Kouk | Phnom Penh

Job Type

FULLTIME

Experience

2+ Years

Experience level

Associate

Work Mode

On-site

Industry

Insurance

Languages

Khmer, English

Description

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 – including trip/claim mismatches or disputed circumstances – coordinating with partner, medical officers, or external investigators, and escalating potential fraud, non-disclosure, 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; support UAT and configuration testing for claims-related system builds.
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.

Requirements

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 interal skills, with empathy and a customer-centric approach; comfortable liaising with an external distribution partner. ing knowledge of Cambodian insurance regulatory requirements or strong willingness and ability to learn quickly.
High level of integrity and discretion in handling confidential and sensitive information.
Comfortable ing within core insurance systems and MS Excel for claims tracking, calculation, and reporting.
Ability to under pressure, manage multiple concurrent cases, and meet deadlines in a fast-moving tup environment.
Proficiency in Khmer and good ing English.

Required Skills

Claims ProcessingInsurance OperationsEmbedded InsuranceBancassuranceDigital/Platform-Distributed ProductsAnalytical SkillsDecision-MakingAttention to DetailCommunicationInterpersonal SkillsEmpathyCustomer-Centric ApproachLiaising with Distribution PartnersCambodian Insurance Regulatory RequirementsLearning AgilityIntegrityDiscretionHandling Confidential InformationCore Insurance SystemsMS Excel

Benefits

Rewards for over performanace
Join an experienced team
Learn new skills on the jobs

About PASSAPP TECHNOLGIES CO.LTD

Industry

Insurance

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Description

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 – including trip/claim mismatches or disputed circumstances – coordinating with partner, medical officers, or external investigators, and escalating potential fraud, non-disclosure, 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; support UAT and configuration testing for claims-related system builds.
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.

Requirements

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 interal skills, with empathy and a customer-centric approach; comfortable liaising with an external distribution partner. ing knowledge of Cambodian insurance regulatory requirements or strong willingness and ability to learn quickly.
High level of integrity and discretion in handling confidential and sensitive information.
Comfortable ing within core insurance systems and MS Excel for claims tracking, calculation, and reporting.
Ability to under pressure, manage multiple concurrent cases, and meet deadlines in a fast-moving tup environment.
Proficiency in Khmer and good ing English.