Claims Executive
- Singapore
- Permanent
- Full-time
- Provide general advice on insurance plan design, policy coverage, benefit limits, main exclusion and self-funded program (if any)
- Provide information on general matters pertaining to the account, for example claim collection date, claim drop-off location and expected turnaround time
- Provide guidance on claim submission process and required documents.
- Provide assistance in checking of claim status
- Explain claim computation / breakdown as per claim settlement provided by insurers
- Provide assistance on appeals for rejected / partially paid claims
- Advise panel clinic location, operating hours and contact number (if applicable)
- Advice on Underwriting Requirements and status of cover requiring underwriting approval by insurer (if applicable)
- Understand client’s needs / requirements and support strategies to enable the team to deliver the expected services
- Create and maintain proper documentation around process guidelines relating to the client’s requirements
- Support and assist the client relationship managers in maintaining a positive relationship with stable operations delivery
- Manage client satisfaction by ensuring employees’ complaints and requests are attended to within the required TAT and SLA
- Provide professional and accurate advice to the clients and service standards to achieve high level of customer satisfaction
- Present Operations Performance Review periodically to client (if applicable)
- Provide accurate and timely reports to clients (if applicable)
- Work with employee, HR and insurer(s) on escalated claims or complaints
- Identify issues and suggest improvements to existing processes for escalated issues pertaining to Operations
- Strong knowledge of insurance plan design and policy coverage.
- Excellent communication and interpersonal skills to provide professional advice and support.
- Experience in claims management or a related field.
- Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
- Familiarity with underwriting requirements and processes.
- Experience in client relationship management and service level management.
- Proficiency in generating reports and presenting operational performance reviews.
- We help you be your best through professional development opportunities, interesting work, and supportive leaders.
- We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have an impact for colleagues, clients, and communities.
- Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.