Claims Analyst – Customer Care & Insurance Operations

About the role

The Claims Analyst is responsible for the day‑to‑day operations of claims and customer‑care functions, including after‑sales service and managing inbound and outbound calls. The role ensures that claims are processed within guidelines, standards and timelines while delivering a high level of customer satisfaction.

Key responsibilities

• Assess, settle and adjudicate insurance claims in accordance with policy provisions.
• Answer inquiries related to claims processing and payments.
• Process all claim documents promptly and make recommendations.
• Follow up on cases to meet service standards and turnaround times.
• Perform daily transactions within approved authority limits.
• Enter and amend data as required.
• Prepare daily statistics and ensure timely case closure.
• Update and review Standard Operating Procedures (SOPs).
• Support team members and test system enhancements.
• Conduct training, knowledge sharing and act as a subject‑matter expert.
• Participate in projects and initiatives related to operations and system improvements.
• Determine eligible benefits based on submitted documents.
• Assist in resolving claims‑related complaints and discuss decisions with management when needed.

Required profile

• Bachelor’s degree, preferably in a medical‑related field.
• Strong understanding of medical terminology for case analysis.
• Excellent analytical, interpersonal and communication skills.
• Ability to work under pressure, handle conflicts and stay self‑motivated.
• Customer‑service orientation with a focus on rapid issue resolution.
• High learning orientation, innovation and motivation to achieve targets.
• Knowledge of claims processing is a plus.
• Fluent in English and Burmese, both written and spoken.

Required skills