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.
Who we are looking for:
Competencies & Personal Traits
- Strong command of the English language (spoken and written)
- Familiarity with human anatomy, general diseases and disease management
Working Experience
- 3 to 4 years of experience as a Life & Health claims assessor
Professional Qualifications
- OMA, FLMI (Fellow, Life Management Institute)
Education
- Degree holder of biology & life sciences discipline
Language
- English
