Claims Manager

Integrated Health Plans; Johor Bahru; On-site; MYR 381,000 - 571,000; Full time

Job summary

Integrated Health Plans is seeking a Claims Manager to lead end-to-end Singapore Medical and Employee Benefits (EB) claims operations, ensuring compliant, efficient, customer-centric processing. You will drive governance, KPIs, and strategic initiatives in collaboration with senior leaders.

The role emphasizes process improvement, automation, and staff development, with a focus on performance, risk management, and stakeholder alignment across the organization.

Qualifications

• 8+ years of progressive medical claims experience in insurance.
• At least 3 years in a leadership role managing Singapore Medical & EB claims operations.
• Experience in governance, regulatory compliance, and risk management.
• Knowledge of Singapore regulations and customer service standards.

Responsibilities

• Lead day-to-day medical and EB claims operations to ensure timely, fair settlement.
• Develop and implement claims strategies and KPIs with senior leadership.
• Drive process improvements and automation within the claims function.
• Oversee SOPs, audit readiness, and governance.
• Mentor claims managers and ensure staff engagement.
• Collaborate with internal and external stakeholders on claims priorities.

Skills

Medical claims leadership

Regulatory compliance

Process optimization

Stakeholder management

Leadership coaching

Education

Insurance professional qualifications

Job description

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Claims Manager is responsible for leading and managing the end-to-end Singapore Medical and Employee Benefit (EB) claim’s operations function, ensuring efficient, accurate, compliant, and customer‑centric claims handling across the organization. The role is accountable for driving operational excellence, claims governance, process optimization, team performance, and service quality while supporting the organization's strategic and business objectives.

The incumbent will work closely with senior leadership team and key stakeholders to develop and execute claims strategies, improve operational efficiency, strengthen risk management controls, and enhance customer experience.

Key responsibilities

Claims Operations Leadership

• Lead and oversee day-to-day claims operations to ensure timely, accurate, and fair assessment and settlement of claims.
• Develop and implement operational plans and initiatives aligned with the organization's strategic objectives.
• Ensure claims processes are executed in accordance with company policies, regulatory requirements, and service standards.
• Monitor claims performance metrics and drive initiatives to improve productivity, quality, turnaround time, and customer satisfaction.

Strategic Planning & Performance Management

• Partner with senior leadership team to develop and execute claims strategies and operational priorities.
• Analyze claims trends, operational data, and performance indicators to identify opportunities for improvement.
• Establish, monitor, and report on key performance indicators (KPIs) and service level agreements (SLAs).
• Prepare and present regular management reports on claims performance, risks, operational efficiencies, and improvement initiatives.

Process Improvement & Operational Excellence

• Identify and implement process improvement initiatives to enhance efficiency, effectiveness, and customer outcomes.
• Drive automation and digital transformation within the claims function.
• Review, update, and enforce claims Standard Operating Procedures (SOPs) to ensure compliance with current regulations and best practices.
• Promote a culture of continuous improvement and operational excellence across the claims team.
• Lead, coach, and develop claims managers and teams to achieve high levels of performance and engagement.
• Foster a culture of accountability, collaboration, customer focus, and continuous learning.
• Oversee workforce planning, recruitment, training, succession planning, and employee development initiatives.
• Conduct regular performance reviews and team engagement sessions.

Risk Management, Compliance & Governance

• Ensure full compliance with regulatory guidelines, company policies, and internal control requirements.
• Identify operational risks and develop mitigation strategies to minimize exposure.
• Oversee claims governance processes, including quality assurance reviews, audit readiness, and corrective action plans.
• Support fraud detection, prevention, and investigation activities in collaboration with relevant stakeholders.

Stakeholder Management

• Build strong relationships with internal stakeholders, including Account Management, Business Development, Benefit Setup, Customer Service, Finance, IT, Compliance, and Risk functions.
• Serve as the primary escalation point for complex, high-value, or sensitive claims matters.
• Communicate effectively with senior management and external stakeholders on claims performance, operational initiatives, and business priorities.

About you

• Minimum 8 years of progressive medical claims experience within the insurance industry
• At least 3 years in a leadership role managing Singapore Medical and Employee Benefits (EB) claims operations, teams, and service delivery
• Demonstrated experience in claims governance, regulatory compliance, process improvement, and stakeholder management
• Strong knowledge of Singapore insurance regulations, industry practices, and customer service standards
• Professional insurance qualifications (e.g., ANZIIF, DMII, AII, ACII) would be an added advantage