Health Claims Executive - Up to S$5.5k - 1 year contract

TALENT EDGE RECRUITMENT LLP; Singapore; On-site; SGD 60,000 - 80,000; Full time

Job summary

A leading recruitment firm in Singapore is seeking a claims adjudicator to manage accident and health claims. The role involves ensuring timely claims decisions, complying with regulations, and collaborating with various stakeholders. Ideal candidates should have claims experience in healthcare and solid medical knowledge. Applications can be sent to the provided email.

Qualifications

• Experience with insurer, TPA, or in healthcare settings.

Responsibilities

• Adjudicate claims and ensure timely decisions.
• Comply with regulatory and corporate guidelines.
• Review and enhance workflow processes.
• Collaborate with underwriters for accurate claims processing.
• Manage relationships with external parties including regulators.
• Investigate claims with claims adjusters and other parties.
• Handle claims-related enquiries and complaints.
• Follow up with claimants for outstanding requirements.

Skills

Claims experience

Good medical knowledge

Job description

Job Description

• Adjudicate Shield and Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time).
• Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.
• Review workflow and claims processes to identify areas of improvement and implement enhancement to achieve efficient claims administration.
• Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.
• Manage working relation with external parties – Central Provident Fund Board (CPFB), regulator, financial consultants, bancassurance partners, medical institutions, etc.
• Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment.
• Manage enquiries, service recovery, complaints and appeal arising from claims.
• Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.

Requirements

• Claims experience with insurer or TPA or Healthcare settings
• Good medical knowledge

Kindly apply online or send your application to [e-mail]

EA: 15C7572