Medical Claims Process Improvement Executive

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

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.