Health Claims Associate - 12 months Contract

1. Health Claims Associate

Principal Accountabilities and Responsibilities (e.g., for Business, Customers and Stakeholders; internal control environment, etc.)

• Conduct In-depth assessment of Outpatient (70%, TAT 14 days) & In-patient Medical (30%, TAT – 21 days) claims in accordance with policy contract and guidelines
• Ensuring emails and telephone call inquiries are well-managed and responded in a timely manner
• Ensuring the claim is assessed correctly in accordance with policy contracts and guidelines and approved within the Authority Limit given.
• Ensuring claim settlement is concluded within the agreed Turnaround Time (TAT)
• Investigate and escalate technical claim issues as and when experienced"

Leadership and Teamwork

• Continuous communication with both internal and external customers and providing the required support with the objective of providing quality claim service experience
• Assist in providing necessary information and ad-hoc assignments to Senior Manager / Manager to allow for accurate and timely submission of reports to management.

Functional Knowledge

• A recognized Diploma or Degree in any discipline
• Minimum of 1 – 2 years of related work experience in the insurance industry, preferably experience with handling Outpatient and inpatient health claims
• Knowledge of AS400 and Salesforce an advantage
• Proficient in Microsoft Office application.

Others

• Excellent verbal and written communication skills and interpersonal skills
• Able to work independently and a fast learner, able to grasp processes and systems quickly
• Able to multi-task and work under pressure to meet tight deadlines in a fast-paced environment
• Strong customer orientation, team player
• Flexibility to work shifts.
• Ability to build rapport with and relate to a wide range of people.
• Strong analytical and problem-solving skills along with being organized, and structured. methodological and assertive.
• Strong interpersonal and customer servicing skills.