InsurTech Subject Matter Expert - Claims (Life & Health)

Antal International Network; Singapore; Remote; Confidential; Full time

Job summary

A leading InsurTech platform is seeking an SME in Claims to enhance their offerings in the health insurance sector. The ideal candidate will have significant experience in claims operations and will work remotely, participating in key discussions to streamline processes and improve workflows.

Qualifications

• Minimum 6+ years of experience in life/health claims operations or consulting roles.
• Sound knowledge of claims processing workflows and adjudication logic.
• Familiarity with fraud patterns, medical codes, and clinical documentation.

Responsibilities

• Participate in workshops with claims heads, adjudicators, and operations teams.
• Define and document health claims flows from pre-authorization to payment.
• Assist in the configuration of rules for eligibility, benefit payouts, and fraud scenarios.

Skills

Claims processing workflows

Adjudication logic

Communication skills

Job description

Our client is a VC-fundedInsurTech platform company, providing software platforms for Life Insurance and Health Insurance companies across the globe.Leveraging their domain expertise, regulatory knowledge and technology experience, they architect innovative products and disrupt the Insurance value chain from Customer Acquisition to Engagement. Their products serve customers across the APAC region.

• Title / Designation : SME (Subject Matter Expertise) – Claims
• Reporting Manager: Chief Product Officer/ Head of Business Solutions Group
• Work Mode: Remote

Role & responsibilities:

• Participate in workshops with claims heads, adjudicators, and operations teams.
• Define and document health claims flows — from pre-authorization to payment.
• Assist in the configuration of rules for eligibility, benefit payouts, and fraud scenarios.
• Validate ICD/PCS code mapping, duplicate check logic, and claim audit workflows.
• Provide input for STP configurations and workbench design.

Candidate requirements:

• Minimum 6+ years of experience in life/health claims operations or consulting roles.
• Sound knowledge of claims processing workflows and adjudication logic.
• Familiarity with fraud patterns, medical codes, and clinical documentation.
• Understanding of platform configuration and integration with policy systems.
• Good communication skills to work with both business and technical stakeholders.

Selection process:

• Interview by Chief Product Officer/ Head of Business Solutions Group

Upload your resume and our tool will compare it to the requirements for this job like recruiters do.