Medical Underwriting & Claims Doctor

About the role

The Medical Underwriting & Claims Doctor will assess risk on insurance applications, determine appropriate coverage and premiums, and conduct fair claims reviews in line with Daiichi Life Insurance Myanmar’s policies. This role bridges clinical expertise with insurance operations to ensure financial soundness and high‑quality service for customers.

Key responsibilities

• Perform risk assessments on insurance applications and set suitable premiums.
• Communicate with customers, sales teams, hospitals, and internal stakeholders via email, phone, and other channels.
• Coordinate medical examinations, interpret reports, and liaise with accredited hospitals.
• Provide health‑care industry data for product development and support underwriting decisions.
• Attend underwriting and claims committee meetings, deliver training, and present findings.
• Report application and policy status regularly and conduct monthly quality audits.
• Handle post‑issuance underwriting changes, such as travel, reinstatements, and group renewals.
• Assess health‑insurance claims, work with third‑party administrators, and ensure timely resolution.
• Conduct AML checks and report positive results to management.
• Participate in user acceptance testing for new products and system enhancements.

Required profile

• Medical Doctor qualification with strong clinical knowledge.
• Excellent analytical ability to evaluate risk and interpret medical data.
• Effective communication skills for interaction with diverse stakeholders.
• Commitment to continuous improvement and willingness to pursue certifications such as LOMA, ALU, or ICA.
• Detail‑oriented mindset with a focus on compliance and quality.

Required skills

• Medical underwriting expertise.
• Claims assessment experience.
• Familiarity with the Jet Underwriting system.
• User Acceptance Testing (UAT) capabilities.
• AML compliance procedures.