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Claims QA Specialist (1 year contract)

PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED

Singapore

On-site

SGD 60,000 - 85,000

Full time

19 days ago

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Job summary

A leading insurance provider in Singapore is seeking a competent Life & Health claims assessor to ensure timely and accurate claims processing. The successful candidate will have a strong background in life and health insurance claims, excellent communication skills, and a degree in biology or life sciences. This role offers an opportunity to deliver quality service and contribute to ongoing projects within the organization.

Qualifications

  • 4 years of experience as a Life & Health claims assessor.
  • Professional qualification: OMA, FLMI.

Responsibilities

  • Review and assess shield claims within the service turnaround time.
  • Attend to claims investigations and customer enquiries.
  • Involve in UAT testing and liaise with project teams.

Skills

Strong command of English
Familiarity with human anatomy
Knowledge of disease management

Education

Degree holder of biology & life sciences discipline

Job description

Job Description:

  • Review, assess and approve shield claims within service turnaround time. Ensure the output is accurate and compliant to internal policy and regulatory requirements.
  • Attend to claims investigations, service recovery and enquiry
  • Attend to medical clarification with hospitals and clinics
  • Involve in projects assigned by supervisor
  • Provides quality customer service including interacting with customers, answering customer enquiries and effectively handling customer complaints
  • Review the rules of Straight through (STP) process of PP claim from web, data capture tools, MedLM etc.
  • Involve in UAT testing i.e. involved in the Quality check of the cases adjudicated by the MedLM vis-à-vis the cases finalised by claim assessors
  • Liaise with the project team of MedLM to ensure smooth delivery of the MedLM system

Who we are looking for:

Competencies & Personal Traits

  • Strong command of the English language (spoken and written)
  • Familiarity with human anatomy, general diseases and disease management

Working Experience

  • 4 years of experience as a Life & Health claims assessor

Professional Qualifications

  • OMA, FLMI (Fellow, Life Management Institute)

Education

  • Degree holder of biology & life sciences discipline
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