Job Details

Job Type
Sherry Lim
Contact email
Email Sherry
Contact phone
65 6692 9345
about 1 month ago
Join an established health insurance services provider as Senior Manager, Medical Claims. In this role you will be responsible for medical advice, claims adjudication of controlled claims. You will manage claims audits and claims reporting duties. You will assist the overall claims team and business to deliver appropriate decisions and recommendations , effectively claims manage and minimise operational risks. This is a role with global exposure servicing clients across APAC, EMEA.

Key responsibilities 
  1. Controlled claims management, provide medical support and claims adjudication, including claims reporting function to EXCOM
  2. Claims Audit Management in accordance with annual schedule. Review, control and update audit policies and deliver reports to clients and the business. 
  3. Contribute via policy wording review design and interpretation 
  4. Claims training 
  5. Contribute to FWA strategy and approach to ensure all deliverables are met in TPA servicing agreements 
Key Experience
  1. Medical background and/or training 
  2. Strong experience with health insurance claims handling 
  3. At least 10-12 years of relevant claims experience 
  4. Strong claims quality control
  5. Strong customer service orientation, excellent stakeholders engagement skills