Senior Medical Claims Adjuster
Since its founding in Cambodia in 1999, Forte has remained true to its mission to provide innovative customer-focused products and services, build capacity in people, and contribute to the progress of the insurance industry in markets they operate in. Offering both general and life insurance in Cambodia, and general insurance in Laos, Forte is the preferred partner of multinational insurers.
Forte is also an employer of choice which offers a collaborative workplace that rewards achievement and provides opportunities for employees to grow through professional education and development.
Position Overview
The Senior Medical Claims Adjuster is responsible for managing complex and high-value medical insurance claims, ensuring accurate assessment, compliance with policy terms, and timely resolution.
Key Responsibilities
- Claims Assessment:
- Review and process complex medical claims, including hospitalization, surgical, and outpatient cases.
- Verify coverage, eligibility, and compliance with policy terms.
- Investigation & Analysis:
- Analyze medical reports, invoices, and treatment plans to determine claim validity.
- Liaise with healthcare providers, policyholders, and third-party administrators for clarification.
- Settlement & Negotiation:
- Calculate and approve claim payments within authority limits.
- Negotiate settlements for disputed or high-value claims.
- Compliance & Documentation:
- Ensure adherence to regulatory requirements and company guidelines.
- Maintain accurate claim records and prepare detailed reports.
- Leadership & Mentorship:
- Guide and support junior medical claims staff.
- Assist in developing best practices and process improvements.
Requirements:
- Medical Doctor, bachelor’s degree in medical science or related field.
- Experience in medical claims adjusting or healthcare insurance is advantage.
- Strong understanding of medical terminology, procedures, and billing practices.
- Excellent analytical, negotiation, and communication skills.
- Proficiency in claims management systems and MS Office.
- Experience in handling complex or international medical claims.
- Ability to work under pressure and manage multiple priorities.
IN RETURN, WE OFFER
- A competitive salary.
- Great career progression opportunities.
- Comprehensive training.
- A friendly and supportive working environment.
Please forward your detailed resume including a recent photograph with a cover letter describing your suitability for the role, career aspirations and salary expectation to:
Office Address : # Vattanac Tower, Level18 No.66 Monivong Blvd, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh, Cambodia
Email : humanresource@forteinsurance.com
CLOSING DATE : 15 February 2026. Only shortlisted candidates will be notified.
