Claims & Operations Manager

Found in: Talent SG 2A C2 - 3 weeks ago


Singapore AUTHENTIC HR PTE. LTD. Full time
Roles & Responsibilities

Work Location: Central Region

Work Days: 5.5

Working Hours: Monday to Friday: 9 am to 6 pm

Saturday: 9 am to 1 pm


Job Responsibilities


I. Claims Management:

  1. Manage and audit all claims forms and medical reports.
  2. Liaise with clinics and hospitals regarding claims and medical reports.
  3. Ensure Policy Holder's (PH) questionnaire and claim forms are completed and submitted to the Insurer on time.
  4. Ensure pre- & post-hospitalization claims are filed with the Insurer promptly.
  5. Monitor claim progress for each admission and/or case closely.
  6. Maintain and update PH's claim summary.
  7. Retrieve claims updates from hospitals and centers, PHs, or their Insurance Companies and upload them to the Company Connect Portal.
  8. Provide claims status updates to stakeholders through the respective channel.
  9. Update the final bill and claim closure.
  10. Pre-assess each case submission and audit the Estimated Claim Spreadsheet (ECC).
  11. Study various health insurance products and monitor claim assessment and approval trends for different products.
  12. Participate in improving claims submission and management processes.
  13. Provide claims advice to the Business Development Team.
  14. Conduct monthly claims review meetings monthly and generate ad-hoc reports when required.
  15. Train and manage junior claims associates to meet claims department KPIs consistently.


II. Operations:

  1. Ensure the operation process is smooth and seamless by overseeing and auditing the processes below:
  2. Supervise the operation process for quality control and participate in improving the company sales operation process.


III. Data & Systems Management:

  1. Update and ensure the accuracy of the information, including, but not limited to, details of PH, admission, discharge, procedure, surgical code/table, and insurance policy for each entry.
  2. Ensure PH's information, medical reports, bills, and claim submissions are filed adequately into the system according to the Company's protocol.
  3. Assist and participate in system improvement.


IV. Others:

  1. Organize, schedule, and/or assist with company meetings and events.
  2. Take accurate meeting minutes and ensure proper documentation filing.
  3. Perform other ad-hoc duties assigned by seniors and management, especially during and/or after office hours.


Job Requirements

  1. At least 3 years of experience handling health and personal accident claims.
  2. Strong relationship management skills and interpersonal and communication skills, both written and verbal.
  3. Ability to understand and resolve issues effectively.
  4. Adaptable, resilient, able to multitask, and work well in a dynamic and fast-paced environment.
  5. Confident and passionate about customer service quality.
  6. Resourceful, proactive, and analytical with an eye for detail.
  7. A good team player, meticulous, organized, highly adaptable, and flexible in supporting all ad-hoc duties.
  8. Protect information security and provide responses to queries prompt and detail.



Tell employers what skills you have

Relationship Management Skills
Claims Management
Able To Multitask
Quality Control
Hospitals
insurance products
Protocol
Adaptable
Communication Skills
Team Player
Customer Service
Health Insurance
Audit
leadership skills
  • Senior/ Manager, Business Operations

    Found in: Talent SG 2A C2 - 6 days ago


    Singapore DOCTOR ANYWHERE OPERATIONS PTE. LTD. Full time

    Roles & ResponsibilitiesAbout the teamDoctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top...


  • Singapore Doctor Anywhere Operations Pte. Ltd. Full time

    About the teamDoctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.We are seeking a...

  • Claim Coordinator

    2 weeks ago


    Singapore Glass-fix Pte. Ltd. Full time

    Overview:As a Claims Coordinator in Glass- Fix , you will be provided with comprehensive training to effectively manage insurance claims, even if you have no prior experience in the field. You will play a crucial role in processing claims and ensuring timely resolution. Your dedication to learning and attention to detail will contribute to maintaining high...

  • Claim Coordinator

    Found in: Talent SG 2A C2 - 2 weeks ago


    Singapore GLASS-FIX PTE. LTD. Full time

    Roles & ResponsibilitiesOverview:As a Claims Coordinator in Glass- Fix , you will be provided with comprehensive training to effectively manage insurance claims, even if you have no prior experience in the field. You will play a crucial role in processing claims and ensuring timely resolution. Your dedication to learning and attention to detail will...

  • Account Executive

    Found in: Talent SG 2A C2 - 1 day ago


    Singapore AMBER BUSINESS CONSULTING PTE. LTD. Full time

    Roles & ResponsibilitiesAdministrative Executive cum accountant assistant行政兼会计助理Job Description工作范围1. Preparing secretarial documents as assigned. (Training and sample will be provided)准备秘书相关的行政文件(会提供培训与文件模版)2. Basic understanding on BS, P&L, GL, AR,...


  • Singapore SINGAPORE TECHNOLOGIES ENGINEERING LTD Full time

    Responsibilities:Report to and assist the Project Director and Package Managers in managing contracts and claims for various projects in the Environmental Engineering Services Department.Writing contractual letters and formulation of claims for Variation Orders, EoT and Loss & Expense.Liaise with various internal departments to collate relevant documents for...


  • Singapore Skylink Group Holdings Pte. Ltd. Full time

    Join Our Growing Team!As Skylink Group Holdings continues to expand, we're looking for passionate and talented individuals to join our journey. Our success has opened up exciting new roles across various departments, offering a wealth of opportunities for professional growth. At Skylink Group Holdings, you'll not only be a part of our success story but also...

  • Accident Claim Manager

    Found in: Talent SG 2A C2 - 3 weeks ago


    Singapore SKYLINK GROUP HOLDINGS PTE. LTD. Full time

    Roles & ResponsibilitiesJoin Our Growing Team!As Skylink Group Holdings continues to expand, we're looking for passionate and talented individuals to join our journey. Our success has opened up exciting new roles across various departments, offering a wealth of opportunities for professional growth. At Skylink Group Holdings, you'll not only be a part of our...

  • Claims Associate

    2 weeks ago


    Singapore Swiss Re Full time

    About the RoleA claims position, responsible for professionally handling International Program (IP) claims triggered under either master or local policies. These IP claims might also require a sophisticated approach to managing issues with clients, brokers, co-insurers internal stakeholders, network partners and service providers.To be part of the APAC Corso...

  • Claims Specialist

    Found in: Talent SG 2A C2 - 13 hours ago


    Singapore JP RECRUITMENT PTE. LTD. Full time

    Roles & ResponsibilitiesAs a Claims Specialist, you will be responsible for ensuring that all claims are processed in a timely way and that payments are made accurately within the turnaround time. The ideal candidate will be in charge of policy liabilities, investigating all claims, calculating/determining the claim amount payment according on policy...

  • Claims Specialist

    1 week ago


    Singapore Jp Recruitment Pte. Ltd. Full time

    As a Claims Specialist, you will be responsible for ensuring that all claims are processed in a timely way and that payments are made accurately within the turnaround time. The ideal candidate will be in charge of policy liabilities, investigating all claims, calculating/determining the claim amount payment according on policy coverage, management rules, and...

  • Claims Associate

    Found in: beBee jobs SG - 2 weeks ago


    Singapore Swiss Re Full time

    About the RoleA claims position, responsible for professionally handling International Program (IP) claims triggered under either master or local policies. These IP claims might also require a sophisticated approach to managing issues with clients, brokers, co-insurers internal stakeholders, network partners and service providers. To be part of the APAC...

  • Head of Claims

    2 weeks ago


    Singapore Aon Full time

    Aon is currently recruiting a Head of Claims - Singapore, who will report to the Asia Chief Claims Officer, and Singapore Chief Broking Officer respectively.Aon is in the business of better decisions At Aon, we shape decisions for the better to protect and enrich the lives of people around the world.As an organization, we are united through trust as one...

  • Claims Assessor

    Found in: Talent SG 2A C2 - 3 weeks ago


    Singapore FULLERTON HEALTHCARE GROUP PTE. LIMITED Full time

    Roles & Responsibilities Assess medical claims in accordance with policy contract and guidelines. Ensure claim settlements are concluded within the agreed turnaround time. Ensure emails and telephone call enquiries are responded in a timely manner. Investigate complex cases or complaints submitted by clients and provide solutions to the case/complaints. ...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S9969Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S10467Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S10127Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S10254Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S10078Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...


  • Singapore Direct Search Asia Pte Ltd Full time

    Job DetailJob Reference S10358Job DescriptionManage H&M (Hull and Machinery), PNI (Protection and Indemnity), FD&D (Freight Demurrage & Defence) and other insurance covers for company's fleetEnsure all claims are filed with relevant insurers in a timely mannerCoordinate with relevant insurers to process various marine claims (hull, cargo, crew & related P&I...