Claims Analyst: Risk & Resolution Specialist

RECRUIT EXPRESS PTE LTD; Singapore; On-site; SGD 42,000 - 66,000; Full time

Job summary

RECRUIT EXPRESS PTE LTD in Singapore is seeking a diligent Claims Analyst to review and assess local and overseas medical and non-medical insurance claims in line with policy terms and authority limits. The role involves evaluating pre-authorization and guarantees, and coordinating with policyholders, healthcare providers, intermediaries, and internal teams to resolve queries and disputes.

You will process settlements and refunds, monitor receivables and overpayments, and prepare claims reports.

Responsibilities

• Review local and overseas medical and non medical insurance claims in accordance with policy terms, authority limits and established turnaround times.
• Review Pre Authorisation and Letter of Guarantee requests; assess eligibility based on policy coverage and applicable medical benchmarks.
• Liaise with policyholders, healthcare providers, intermediaries and internal teams to obtain information, resolve claim queries and handle disputes.
• Process claim settlements and payment related activities including refunds, unsuccessful transfers, CPF related cases, receipt cancellations and claim reprocessing.
• Monitor outstanding receivables and overpayments; coordinate recovery or refunds with claimants, hospitals, insurers and relevant parties.
• Prepare claims reports and analysis; support UAT, system enhancements and process improvements while identifying and escalating potential fraud or claim inconsistencies.

Job description

RECRUIT EXPRESS PTE LTD in Singapore is seeking a diligent Claims Analyst to review and assess local and overseas medical and non-medical insurance claims in line with policy terms and authority limits. The role involves evaluating pre-authorization and guarantees, and coordinating with policyholders, healthcare providers, intermediaries, and internal teams to resolve queries and disputes.

You will process settlements and refunds, monitor receivables and overpayments, and prepare claims reports.