Key Accounts, Service Leader

PACIFIC PRIME INSURANCE BROKERS SINGAPORE PTE. LTD.; Singapore; On-site; SGD 40,000 - 60,000; Full time

Job summary

Pacific Prime Insurance Brokers Singapore Pte. Ltd. is seeking a Diploma-qualified claims administrator to support HR and clients with claims, benefits, and pre-authorisation matters.

You will communicate with members on policy utilisation, investigate claims issues, and liaise with clinics and insurers to ensure smooth processing and timely reimbursements in a dynamic team.

Qualifications

• : Diploma holder with minimum 2 years’ relevant experience in claims administration or client servicing within the insurance industry.
• : Insurance certifications such as BCP, PGI, ComGI, HI will be an advantage.
• : Customer-focused with strong attention to detail, analytical and reconciliation skills.
• : Excellent interpersonal and communication skills
• : Well-organised and able to work effectively in a fast-paced environment.

Responsibilities

• Attend to client enquiries via phone and email on claims, benefits and pre-authorisation matters.
• Communicate with members on utilisation and management of insurance policies.
• Clarify and investigate claims issues and check reimbursements.
• Manage claims appeals with insurers including declined pre-authorisation cases.
• Process pre-authorisation requests and liaise with clinics and providers.
• Handle direct billing and e-claims enquiries for Key Account members.
• Clarify benefit and policy enquiries with insurers.
• Maintain accurate claims records and provide status updates.
• Assist in group presentations, orientations and medical briefings for Key Accounts.
• Prepare service and claims reports and handbooks for renewals or client requests.
• Review insurers’ direct billing facilities and update provider lists and portals.

Skills

Claims administration

Client servicing

Attention to detail

Analytical skills

Communication skills

Education

Diploma

Job description

Key Responsibilities

• Attend to client (HR or employees) enquiries via phone calls and emails in a timely and professional manner, providing support on claims, benefits enquiries, and pre-authorisation matters.
• Communicate effectively and maintain excellent service relationships with members/employees regarding the utilisation and management of their insurance policies.
• Provide full support to HR, group employees, and/or Key Account Managers in clarifying and investigating claims issues (e.g. delayed, pending, or declined claims), including checking on claims reimbursements.
• Manage reasonable claims appeals with insurers, including declined pre-authorisation cases, and explore all possible avenues for resolution.
• Process pre-authorisation requests and emergency procedures, liaising with clinics, healthcare providers, and medical practitioners where required.
• Handle direct billing and e-claims/online portal/mobile app enquiries and issues for Key Account members, including updating relevant materials, platforms, and employee handbooks.
• Liaise with insurers to clarify benefit and policy enquiries relating to claims, coverage, provider networks, and panel clinics.
• Maintain claims records accurately and efficiently, ensuring timely and accurate status updates.
• Assist Key Account Managers with group presentations, employee orientations, and medical briefings.
• Assist in preparing service reports, claims reports, employee handbooks, and other documentation required by Key Account Managers for renewals or client requests.
• Support the team in the regular review of insurers' direct billing facilities (e.g. ensuring updated provider lists are received on time, updating client microsites and PCP portals, etc.) and assist members in locating appropriate healthcare providers.
• Perform any other ad hoc duties assigned by the Team Leader or Senior Manager.

Requirements:

• Diploma holder with a minimum of 2 years of relevant experience in claims administration or client servicing within the insurance industry.
• Insurance certifications such as BCP, PGI, ComGI, and HI will be an advantage.
• Customer-focused with strong attention to detail, analytical, and reconciliation skills.
• Excellent interpersonal and communication skills
• Well-organised and able to work effectively in a fast-paced