Manager (Claims / Pre-authorisation)

2 weeks ago


Singapore Parkway Pantai Full time

Working location:
Bendemeer

  • Supervise and manage a team of assessors for Preadmission Assessment / Letter of Guarantee (LOG) issuance and ensuring that all key deliverables are met.
  • Assist in the review of Preadmission / Letter of Guarantee (LOG) cases in accordance to clients' requirements and policy.
  • Act as the liaison person for both the service providers and clients in the review of Preadmission / Letter of Guarantee (LOG) cases.
  • Ensure accurate review of Preadmission / Letter of Guarantee (LOG) cases in a timely manner.

Key accountabilities:

  • Supervise and manage a team of assessors for Preadmission Assessment / Letter of Guarantee (LOG) issuance and ensuring that all key deliverables are met.
  • Works with internal departments including Key Accounts Managers, Benefits Teams, Channel Relations Management &/or Medical Team.
  • Reconcile outstanding pending case requirements and requests for additional information with Clinics/Doctors/Business Office.
  • Have a sense of urgency without losing attention to detail, and the ability to multitask
  • Ensure Pre Admission &/or LOG process within turnaround time.
  • Assessing and review case within authority.
  • Making appeal on behalf of clinics to Approvers.
  • Handling urgent request from Partners, Benefits Teams and Account Manager.
  • Ensure Preadmission/In-Patient claims assessment align with Partners' contract and practice.
  • Contact hospital/clinic for bills breakdown and clarification.
  • Handle Letter of Guarantee (LOG) request.
  • Reviewing LOG request and approving issuance of LOG within authority.
  • Reviewing and assisting with supersede LOG request
  • Answering and handling enquires from account manager on Preadmission/In-Patient related issue
  • Provide advice and information on insurance contract and medical knowledge
  • Other ad hoc duties and responsibilities as assigned by Superior

Qualifications & Experience:

  • Diploma/Degree holder
  • Minimum 3 years working experience in health claims department or healthcare industry.
  • Proficient in MS office
  • Customer service skill

Additional Information:

  • Meticulous with keen attention to details
  • Articulate and confident
  • Resourceful
  • Team player
  • Independent
  • Able to multitask

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