Executive, Outpatient Claims

Income-Insurance-Limited; Singapore; On-site; SGD 42,000 - 65,000; Full time

Job summary

Income-Insurance-Limited’s Life and Health Operations team is seeking a Claims Specialist to manage IncomeShield claim assessment, with a focus on outpatient claims. You will evaluate policy liability and determine payable amounts guided by policy cover and guidelines.

You will also compile claims reports, escalate cases to management, and liaise with intermediaries, hospitals and external parties while handling enquiries from claimants and supporting the supervisor or Head of Section.

Qualifications

• Diploma or degree in any field.
• Certified in Health Insurance (HI).
• At least 2 years of individual claims experience.
• Experience with IncomeShield claim processing is an advantage.
• Ability to manage insurance claims enquiries and negotiations.
• Strong analytical and numerical skills.
• Team player and self-motivated.

Responsibilities

• Process and assess IncomeShield outpatient claims.
• Assess policy liability and determine payable amounts per guidelines.
• Compile, analyse and submit claims reports as required.
• Prepare reports on claims escalated to management and presented at meetings.
• Handle enquiries and complaints from claimants.
• Liaise with intermediaries, hospitals and external parties.
• Undertake other duties or projects as assigned by supervisor or Head of Section.

Skills

Analytical skills

Numerical ability

Team player

Self-motivated

Education

Diploma or Degree

HI Certification

Job description

The Life and Health Operations (LHO) department plays a pivotal role in ensuring we provide our customers with affordable and comprehensive life and health products, with efficient processes to allow optimal service to our customers.

As part of the team dedicated to manage IncomeShield claim assessment, your key responsibilities include:

• Processing and assessing all types of IncomeShield claims, with a specific focus on outpatient claims
• Assess policy liability, investigate claims and determine the claim amount payable based on Income's policy cover and management guidelines
• Compile, analyse and submit Claims reports as and when required
• To also prepare report on claims cases to be escalated to management and present cases at committee meetings
• Manage enquiries and complaints from claimants
• Liaison with intermediaries, hospitals and various external parties
• Undertake any other duties or projects as assigned by the Supervisor or Head of Section

Job Requirements

• At least obtained a Diploma or Degree in any field
• Certified in Health Insurance (HI)
• Have at least 2 years of individual claims experience. Experience in Shield claim processing and assessment will be an advantage
• Ability to professionally manage insurance claims enquiry and negotiations
• Good analytical skills, meticulous with a flair for numbers to handle complex computations
• Team player and self-motivated