Claims Manager

Integrated Health Plans Sdn Bhd; Johor Bahru; On-site; MYR 380,000 - 507,000; Full time

Job summary

Integrated Health Plans Sdn Bhd, based in Malaysia, is seeking a Claims Manager to lead the end-to-end Singapore Medical and Employee Benefit claims operations, driving governance, efficiency, and customer-centric service. You will report to senior leadership and collaborate with key stakeholders to execute strategic initiatives.

Required: 8+ years in medical claims with 3+ years in a leadership role overseeing Singapore EB claims, strong regulatory acumen, and professional insurance

Qualifications

• Minimum 8 years of progressive medical claims experience within the insurance industry.

Responsibilities

• Lead 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.
• Monitor claims performance metrics and drive initiatives to improve productivity, quality, turnaround time, and customer satisfaction.
• Oversee claims governance processes, including quality assurance reviews, audit readiness, and corrective action plans.
• Lead, coach, and develop claims managers and teams to achieve high levels of performance and engagement.

Skills

Leadership

Stakeholder management

Regulatory compliance

Process improvement

Strategy & governance

Education

Professional insurance qualifications (ANZIIF, DMII, AII, ACII)

Job description

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