Senior Executive, Claims

Income-Insurance-Limited; Singapore; On-site; SGD 60,000 - 90,000; Full time

Job summary

Income-Insurance-Limited is seeking a Claims Specialist based in Singapore to adjudicate, investigate, and resolve life and medical claims. The role requires reviewing medical evidence, policy terms, and documentation to determine validity, with escalation for complex cases to the Claims Manager.

The candidate should have 3+ years in life/medical claims handling, hold Health and General Insurance certifications, and demonstrate strong communication, customer service, and analytical skills.

Qualifications

• Degree in any discipline.
• At least 3 years of experience in Life or Medical Claims handling.
• Certification in Health Insurance and General Insurance (BCP, PGI & ComGI) and Life Insurance qualifications.
• Ability to review and interpret medical reports, hospital bills, policy contract provisions, and investigation findings.
• Excellent communication and interpersonal skills.
• Good customer service, complaint-handling, and stakeholder management skills.
• Strong analytical, investigative, organizational, and time management skills, with attention to detail.

Responsibilities

• Assess and adjudicate Life and Medical claims within authority limits in accordance with policy terms and conditions.
• Conduct claims investigations where necessary, including reviewing medical evidence, policy documentation, and other relevant information to determine claim validity.
• Identify, investigate, and escalation complex claims to the Claims Manager for further review.
• Handle escalation enquiries from policyholders, intermediaries, healthcare providers, and internal stakeholders, providing timely and professional resolutions.
• Handle appeals, complaints, and disputed claims, ensuring fair and consistent outcomes while maintaining a positive customer experience.
• Support continuous improvement initiatives and contribute to enhancing claims processes and customer service standards.
• Perform any other duties as assigned by the Claims Manager.

Education

Any degree

Tools

Health Insurance Certification

General Insurance Certification

Life Insurance Qualifications

Job description

Job Description

• Assess and adjudicate Life and Medical claims within authority limits in accordance with policy terms and conditions.
• Conduct claims investigations where necessary, including reviewing medical evidence, policy documentation, and other relevant information to determine claim validity.
• Identify, investigate, and escalation complex claims to the Claims Manager for further review.
• Handle escalation enquiries from policyholders, intermediaries, healthcare providers, and internal stakeholders, providing timely and professional resolutions.
• Handle appeals, complaints, and disputed claims, ensuring fair and consistent outcomes while maintaining a positive customer experience.
• Support continuous improvement initiatives and contribute to enhancing claims processes and customer service standards.
• Perform any other duties as assigned by the Claims Manager.

Job Specification

• Degree in any discipline.
• At least 3 years of experience in Life or Medical Claims handling.
• Certification in Health Insurance and General Insurance (BCP, PGI & ComGI) and Life Insurance qualifications.
• Ability to review and interpret medical reports, hospital bills, policy contract provisions, and investigation findings.
• Excellent communication and interpersonal skills.
• Good customer service, complaint-handling, and stakeholder management skills.
• Strong analytical, investigative, organizational, and time management skills, with attention to detail.