Key Accountability

1. Medical Authority & Decision Governance

• Act as the central medical authority for all complex and high-risk claims
• Define medical interpretation standards and decision frameworks
• Ensure consistent application of medical logic across all assessors
• 2. Claim Assessor Team Leadership (Quản lý toàn bộ đội ngũ Assessor)
• Lead and manage all Claim Assessors across levels
• Set performance standards combining medical accuracy and operational KPIs
• Ensure resource optimization and team productivity

3. Medical Risk Control & Claim Strategy

• Identify abnormal medical trends and provider risks
• Provide medical insights for claim strategy and loss control
• Lead direction for investigation of suspicious claims

4. Complex Case Resolution (Xử lý hồ sơ phức tạp)

• Make final decision or provide guidance on complex medical claims
• Liaise with doctors, hospitals, and experts as needed

5. Medical Standardization & Capability Building (Chuẩn hóa y khoa và phát triển năng lực)

• Build internal medical guidelines and knowledge base
• Train assessors on diseases, treatments, and medical interpretation
• Improve overall technical competency of team
• Regular update on new illnesses, treatments

6. Stakeholder & Dispute Management:

• Represent Claims in medical-related disputes
• Working with product development on medical advice and translation (such as
• Critical illness definition …)

Job Requirement

1. Education

• Medical degree is highly preferred (Doctor/General Practitioner)
• Additional qualifications in Insurance, Actuarial, or Healthcare Management are an advantage

2. Experience

• 3+ years of experience in Claims, Medical Insurance, or Healthcare-related roles
• Minimum 1 years in leadership/managerial position (leading assessor or claim teams)
• Proven experience in handling complex medical claims (Cancer, CI, high-value claims)

3. Technical Skills

• Strong clinical interpretation (diagnosis, treatment, medical records review)
• Deep understanding of insurance products, policy wording, and claim practices
• Ability to translate medical knowledge into claim decisions and operational rules
• Strong analytical skills in identifying claim trends, provider risks, and fraud indicators

4. Behavioral Competencies

• Sound judgment and decision-making under complex and sensitive situations
• High level of integrity and professional accountability
• Ability to balance customer-centric approach with business and risk considerations
• Strong stakeholder management and communication skills

5. Language Proficiency

Good command of English (reading medical documents, reporting, communication with reinsurance teams).

Benefits:

• Competitive salary (100% salary during probation).
• Bonus: 13th-month salary and the performance-based bonus of up to 30% of the total annual package.
• Full social insurance, personal accidental & health care insurance, group life insurance (death and dismemberment).
• Gifts for new comers and on special occasions
• Modern facilities in the spacious office 
• 20 Annual leaves