Executive, Claims

Alliance Healthcare Group; Singapore; On-site; SGD 40,000 - 70,000; Full time

Job summary

Alliance Healthcare Group in Singapore is seeking dynamic professionals to join our Claims team in our corporate managed healthcare business. The role centers on accurate adjudication of medical claims and efficient processing to meet SLA targets.

You will drive process improvements, manage escalations, and provide training to ensure effective claims management while liaising with insurers to resolve exceptions and present analyses when needed.

Qualifications

• Strong technical understanding of the medical claims process in a Third-Party Administrator/Managed Healthcare environment.
• Highly developed interpersonal skills.
• Excellent organizational skills and exceptional eye for detail.
• Passionate about driving change to improve business outcomes.
• Exceptional communication and stakeholder management skills.

Responsibilities

• Provide accurate and efficient adjudication of medical claims and pre-authorization of applications.
• Validate and issue Letters Of Guarantee (LOG) to meet SLA targets.
• Review current claims processes and develop improvements to boost efficiency and claims experience.
• Manage escalations and stakeholder relations.
• Champion change and deliver ongoing training for effective claims management.
• Liaise with insurers to verify exceptions and resolve complaints.
• Conduct analysis and prepare periodic reports and presentations.

Skills

Interpersonal skills

Organizational skills

Attention to detail

Change management

Communication

Stakeholder management

Job description

About the Opportunity

We are seeking for dynamic professionals to join our Claims team in our corporate managed Healthcare business.

What You'll be Doing

• Provide accurate and efficient adjudication of claims, validation, pre-authorization of applications and Letter Of Guarantee (LOG) issuance to meet operational and SLA targets.

• Conduct regular review of current claims processes and working with internal stakeholders on developing new and improved processes to improve efficiency and overall claims experience.

• Manage escalations and stakeholder relations.

• Being a champion for change as well as providing on-going training and development for effective claims management.

• Liaise with the Insurance Company to verify exceptions as well as to resolve any complaints.

• Conduct analysis, prepare periodic reports and presentation when required.
  

What We Are Looking for

• Strong technical understanding of the claims process for medical claims, preferable in a Third-Party Administrator/Managed Healthcare environment.

• Highly developed interpersonal skills.

• Excellent organizational skills and exceptional eye for details.

• Passionate about driving change to improve business outcomes.

• Exceptional communication skills and stakeholder management skills.

We regret to inform that only shortlisted applicants will be notified for an interview.

To learn more about our Organization, please visit https://alliancehealthcare.com.sg.