Assistant Manager, Medical Claims (Accident & Health) (6 months contract)

PERSOL; Singapore; On-site; SGD 48,000 - 72,000; Full time

Job summary

Persol is recruiting for an Accident & Health claims assessor to evaluate policy coverage, assess medical claims, and ensure timely, fair decisions in line with policy terms and regulations.

You will liaise with policyholders and medical institutions, process claims, and contribute to service-improvement initiatives while maintaining high customer service standards within a collaborative team.

Qualifications

• 3+ years in Accident & Health claims assessment or similar.
• Experience in Life and Personal Accident claims a plus.
• Ability to interpret medical information and explain conditions in an insurance context.
• Strong written and verbal communication; customer-focused and meticulous.

Responsibilities

• Assess policy coverage and determine proof of loss based on policy terms and docs.
• Evaluate and process medical claims accurately and timely.
• Ensure claims payments are processed accurately according to procedures.
• Review manually submitted claims for completeness of information.
• Liaise with policyholders, medical institutions, and other parties for clarifications.
• Deliver excellent customer service and maintain relationships with policyholders and channels.
• Handle escalated inquiries professionally and provide timely resolutions.
• Ensure compliance with internal policies, SOPs, regulatory requirements, and legal obligations.
• Participate in service-improvement initiatives and ad hoc projects.

Skills

Analytical skills

Written communication

Verbal communication

Team player

Interpersonal skills

Detail-oriented

Proactive process improvement

Adaptability

Education

Diploma/ Degree / Professional Insurance Certificate

Job description

About the Job

You will be responsible for assessing and processing Accident & Health insurance claims, ensuring accurate, timely, and fair claims decisions in accordance with policy terms, regulatory requirements, and internal guidelines. You will also have the opportunity to contribute to service excellence initiatives and projects aimed at enhancing the overall claims experience.

Key Responsibilities

• Assess and determine policy coverage and establish proof of loss based on relevant policy terms and supporting documentation.

• Evaluate and process medical claims accurately and efficiently, meeting the required service standards and turnaround times.

• Ensure claims payments are processed accurately and promptly in accordance with approved procedures.

• Review and process manually submitted claims, ensuring all required information and documentation are complete.

• Liaise with policyholders, medical institutions, and relevant parties to obtain clarifications and outstanding documents required for claims assessment.

• Deliver excellent customer service while maintaining strong relationships with policyholders and distribution channels.

• Handle escalated claims enquiries professionally, providing timely resolutions and appropriate follow-up.

• Ensure compliance with internal policies, standard operating procedures, regulatory requirements, and applicable legal obligations.

• Participate in service improvement initiatives and undertake ad hoc projects or duties as assigned by the supervisor.

Requirements

• Diploma, Degree, or Professional Insurance Certificate, with at least 3 years of relevant experience in Accident & Health claims assessment.

• Prior experience in Life and Personal Accident (PA) claims will be an added advantage.

• Strong analytical, written, and verbal communication skills, with the ability to interpret information and make sound assessment decisions.

• Good medical knowledge and the ability to interpret medical information and explain medical conditions within an insurance claims context.

• Customer-focused, meticulous, and well-organised, with the ability to manage multiple priorities and work effectively under pressure.

• A strong team player with good interpersonal skills and a collaborative mindset.

• Demonstrates integrity, accountability, professionalism, and a positive attitude towards teamwork.

• Proactive in identifying opportunities for process improvement and adaptable to changes in business needs and working practices.

We regret to inform that only shortlisted candidates will be notified.