Claims Executive

PACIFIC PRIME INSURANCE BROKERS SINGAPORE PTE. LTD.; Singapore; On-site; SGD 36,000 - 48,000; Full time

Job summary

Pacific Prime Insurance Brokers Singapore Pte. Ltd. is hiring a Claims Administrator to deliver high-quality service to HR teams and employees. You will handle claims, benefits inquiries, and pre-authorisation matters, while supporting Key Account Managers with investigations and reporting.

The role requires a diploma and at least 2 years in claims or client servicing in insurance, with a focus on accuracy, attention to detail, and strong communication skills.

Qualifications

• 2+ years of experience in claims administration or client servicing within the insurance industry.
• Insurance certifications such as BCP, PGI, ComGI, and HI will be an advantage.
• Customer-focused with strong attention to detail, analytical and reconciliation skills.

Responsibilities

• Attend to client inquiries via phone and email regarding claims, benefits, and pre-authorisation in a timely, professional manner.
• Communicate with members on policy utilisation and management of insurance policies.
• Support HR, group employees, and Key Account Managers in clarifying and investigating claims issues, including reimbursements.
• Manage claims appeals with insurers and explore resolution avenues.
• Process pre-authorisation requests and liaise with clinics and healthcare providers as required.
• Handle direct billing and e-claims enquiries for Key Account members and update relevant materials.
• Clarify benefit and policy enquiries with insurers, maintain claims records, and provide timely status updates.
• Assist in preparing service, claims reports and employee handbooks for renewals or client requests.
• Support team in reviewing insurers' direct billing facilities and help members locate providers.
• Perform any other ad hoc duties as assigned by Team Leader or Senior Manager.

Skills

Customer service

Attention to detail

Analytical skills

Reconciliation

Education

Diploma

Job description

Key Responsibilities

• Attend to client (HR or employees) enquiries via phone calls and emails in a timely and professional manner, providing support on claims, benefits enquiries, and pre-authorisation matters.
• Communicate effectively and maintain excellent service relationships with members/employees regarding the utilisation and management of their insurance policies.
• Provide full support to HR, group employees, and/or Key Account Managers in clarifying and investigating claims issues (e.g. delayed, pending, or declined claims), including checking on claims reimbursements.
• Manage reasonable claims appeals with insurers, including declined pre-authorisation cases, and explore all possible avenues for resolution.
• Process pre-authorisation requests and emergency procedures, liaising with clinics, healthcare providers, and medical practitioners where required.
• Handle direct billing and e-claims/online portal/mobile app enquiries and issues for Key Account members, including updating relevant materials, platforms, and employee handbooks.
• Liaise with insurers to clarify benefit and policy enquiries relating to claims, coverage, provider networks, and panel clinics.
• Maintain claims records accurately and efficiently, ensuring timely and accurate status updates.
• Assist Key Account Managers with group presentations, employee orientations, and medical briefings.
• Assist in preparing service reports, claims reports, employee handbooks, and other documentation required by Key Account Managers for renewals or client requests.
• Support the team in the regular review of insurers' direct billing facilities (e.g. ensuring updated provider lists are received on time, updating client microsites and PCP portals, etc.) and assist members in locating appropriate healthcare providers.
• Perform any other ad hoc duties assigned by the Team Leader or Senior Manager.

Requirements:

• Diploma holder with a minimum of 2 years of relevant experience in claims administration or client servicing within the insurance industry.
• Insurance certifications such as BCP, PGI, ComGI, and HI will be an advantage.
• Customer-focused with strong attention to detail, analytical, and reconciliation skills.
• Excellent interpersonal and communication skills
• Well-organised and able to work effectively in a fast-paced