Personal Accident & Travel Claims Medical Supervisor

Who we are

American International Group Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks.

Were also committed to making a positive difference for our colleagues and in the communities where we work and live. We encourage colleagues to give back to the causes they care most about supporting these efforts through our Volunteer Time Off and Matching Grants Programs.

Get to know the business

General Insurance is a leading provider of insurance products and services for commercial and personal insurance customers. It includes one of the worlds most far-reaching property casualty networks. General Insurance offers a broad range of products to customers through a diversified multichannel distribution network.

The claims function is meant to be a partner to the business segments offering support expertise and partnership. The existing diversity of the business portfolio demands from the claims role specialized expertise in the different business areas. The A&H claims team works with the business to support a wide array of products and offerings through a complex and highly demanding distribution force and network. Claims has the responsibility of delivering and materializing the product offer and the case of A&H this opportunity is given in even the most sensible and highly complex situations where the health and well being of our insureds and clients is touched and where we can make a significant difference at that level.

About the role

What you need to know:

Medical examiner and supervisor of personal accident and serious illness claims responsible for medical and surgical authorizations as well as supervision of the operational management of business lines with technical opinion with participation and medical opinion in reconsiderations of health claims and medical auditor in medical care based on injury diagnosis.

Your contribution at AIG

The employee will be in charge of supervising and issuing medical advice on personal accident and health coverage for Serious Illness coverage with an approximate claims volume of 200 cases.

Duties and Responsibilities

1. Functional Responsibilities:

Provide follow-up and solutions to claims requests received from insured parties and medical units regarding medical and surgical care for accidents as well as attention to claims for compensation for serious illnesses.

Managing key claims handling enquiry; coverage determination quantum analysis and legal liability assessment where appropriatefor high value complex claims such as cancer muscular dystrophy sclerosis heart attacks strokes as well as highly specialized surgeries based on the organizations best practices.

Ensure effective management of healthcare providers and litigation within a personal mission including demonstrable savings such as management of important medical trends

Reporting key claims messages to their Team Manager and to internal stakeholders

Broader internal / external stakeholder communication where required as (LoB) technical claims expert and thought leader

Delivery of technical training to colleagues and external contacts as appropriate

Assist in continuous improvement across the region through support for the Quality Assurance / Regional Audit processes (potentially assisting Team Manager to complete monthly quality assurance reviews)

Ensure adherence to best practice procedures for (LoB) Complex claims consistent with global best practice.

Handle higher level of complexity claims Complex losses within authority limits

2. Accountabilities:

Key contact for resolving claims requests received from insured persons and medical units relating to medical and surgical care for accidents as well as handling claims for compensation for serious illnesses.

Timely accurate and customer focused claim resolution minimizing indemnity exposure and mitigating vendor and legal expense

Effective communication and management of key advanced Complex claims and (LoB) portfolio messages to internal stakeholders and customers/clients.

Financial control through consistent reserve and other financial transaction discipline

Accurate and consistent policy interpretation.

Medical audits of our provider network

3. Leadership Skills

Professional with a high sense of urgency conflict resolution empathy and high communication skills

Excellent communication skills both written & verbal

Good presentation skillsand medical file knowledge

Time management ability to manage & prioritize workload and diary management

Ability to contribute effectively within a team environment and with internal/external stakeholders at all levels

Ability to assist with technical medical training to team claim handlers as required

Ability to influence claims and non-claims stakeholders to effectively direct claims strategy

4. Technical Skills and Expertise

Knowledge of general medicine

Knowledge in the preparation and reading of medical reports and interpretations

Expert in identifying injuries and/or degenerative diseases

Experience and knowledge in personal accident and health claims.

Policy language skills enabling accurate and consistent policy wording interpretation.

A advanced andthorough knowledge of legal / regulatory and litigation / proceduralrequirements for their line of business

Experience in negotiation mediation and arbitration on complex claims

Experience in effectively following up onrecommendations from technical claims audits and continuous file handling improvement

What were looking for:

• Experience:
  • Bachelor of Medicine
  • At least 3 years of claims handling or case management for medical or personal accident claims portfolio
  • At least 2 years of handling and managing medical service providers networks cost containment strategies and continuous improvement strategies.
  • Medium to advanced policy wording interpretation and claims resolution on personal accident or medical expenses policies.
  • People management experience is not required but is a plus.
  • Proven experience in the handling of complex case management (e.g. cancer muscular dystrophy sclerosis heart attacks strokes as well as highly specialized etc.).
• Along with technical skills required for the job soft skills like effective broker engagement teamwork proactive claims management effective time management/priorization calendar organization.
• Effective analytical and attention to detail.

Ready to accelerate your career We would love to hear from you.

At AIG we value in-person collaboration as a vital part of our culture which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive connected environment for our team and clients alike.

Enjoy benefits that take care of what matters

At AIG our people are our greatest asset. We know how important it is to protect and invest in whats most important to you. That is why we created our Total Rewards Program a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health wellbeing and financial securityas well as your professional developmentto bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the worlds most far-reaching property casualty networks. It is an exciting time to join us across our operations we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG you can go further to support individuals businesses and communities helping them to manage risk respond to times of uncertainty and discover new potential. We invest in our largest asset our people through continuous learning and development in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of inclusion

Were committed to creating a culture that truly respects and celebrates each others talents backgrounds cultures opinions and goals. We foster a culture of inclusion and belonging through learning cultural awareness activities and Employee Resource Groups (ERGs). With global chapters ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIGs greatest assets and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race color religion age gender gender expression national origin veteran status disability or any other legally protected categories.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation please send an email to .