Responsibilities:

• Provide medical guidance and manage Controlled Claims in compliance with contractual arrangements, ensuring accurate reporting to stakeholders.
• Conduct Claims Audits according to the Annual Audit Schedule and deliver comprehensive reports aligned with company standards.
• Collaborate on policy wording and claim processes, offering training to partners and stakeholders.
• Identify and address potential fraudulent claims, ensuring proper rectification procedures are followed.
• Deliver ongoing training and best practice guidelines on claims processing to internal and external stakeholders.
• Prepare monthly management reports to track claims and operational metrics.
• Be on standby to manage urgent claims approvals during after-office hours, one week per month.

Requirements:

• Medical degree or relevant experience in nursing or allied health professions is preferred.
• Strong understanding of the healthcare and insurance sectors.
• Proven background in managing health insurance claims.
• Excellent communication abilities, ensuring clear interactions with various stakeholders.
• Dependable and committed to fulfilling responsibilities effectively.

Interested candidates who wish to apply for the advertised position, please click on “Apply”. We regret that only shortlisted candidates will be notified.

EA License No.: 01C4394 (Persol Singapore PTE LTD)

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