Claim Ops Specialist

Innovate Consulting LLP; Singapore; On-site; SGD 60,000 - 80,000; Full time

Job summary

A leading consulting firm in Singapore is seeking an experienced claims expert specializing in Life Claims. The role involves performing product reviews, managing stakeholder communications, and supporting compliance reporting. Candidates should have a diploma/degree and at least five years of experience in Life Claims, demonstrating strong analytical and communication skills. The position requires the ability to work under pressure and a customer-centric attitude.

Qualifications

• Five or more years of experience in Life Claims.
• Strong background in Life & Integrated Shield claim processes.
• Customer-centric approach and ability to work under pressure.

Responsibilities

• Perform product reviews and coordinate teams for medical and life claims.
• Serve as a Claim Subject Matter Expert and liaise between Claim Business and technical teams.
• Support the Claims team in compliance reporting and monitoring.

Skills

Life Claims Expertise

Policy Language Interpretation

Critical Thinking

Communication Skills

Analytical Skills

Education

Diploma/Degree

Job description

Responsibilities

• Product Review (Medical and Life Plans)
  • Perform Review of Contract and Product Specification, including providing requirements for system changes, coordinating/solicit teams inputs, workgroup discussions on medical and life claims.
  • Be part of the product implementation workgroup and have opportunity work with various internal and/or external parties.
• System Support
  • Serves as a Claim Subject Matter Expert, as a liaison and reference point between Claim Business and the Business Analyst (BA)/Technical analyst, ensuring that the business requirement are translated to functional requirements
  • Conduct prioritization with BA and IT on system enhancements
  • Support all production issues, rectifications, data patches/configuration changes or tasks that requires some testing etc. o Involved in ongoing requirement gatherings
  • Review impact/process changes due to system changes
  • UREQ/BSD review from claim business user perspective
• Engagement, communication & briefing to stakeholders on impact areas in relation to system/product/benefit changes
• Governance
  • Management of work instructions and documentation control
  • Ensure governance and due diligence over claim processes and services engaged by Claims Section
• Perform claim peer review inspection
• Review and suggest process improvements for developing or implementing best practices. Lead and participate in operation efficiency projects to bring efficiency to claims processes
• Support the Claims team in any compliance reporting, monitoring/reporting of exceptions, claim financial tracking, planning, and strategizing of claims management and other related duties
• Work closely and maintain good rapport with representatives (financial consultants, advisers, brokers, etc.), officers and staff of other departments to carry out his/her work effectively
• Communicate effectively with reinsurers, auditors and external stakeholders such as the CPF Board, and hospitals, clinics, nursing homes in the course of claims administration or audits
• Conduct Claims Workshops to financial advisors when the need arises
• Undertake any projects or duties, including administrative duties, as assigned by Section Manager or Head of Function

Qualifications

• Diploma/Degree holder with five or more years of experience in Life Claims
• Strong background in Life & Integrated Shield claim processes
• Strong policy language skills enabling accurate and consistent policy wording interpretation
• Strong critical thinking skills and ability to handle complex computations
• Strong written and communication skills, committed team player
• Ability to work under pressure and manage deadlines
• Meticulous with good analytical, organisational skills
• Able to multi-task and work independently
• Customer centric