
Clinical Claims Reviewer
2 weeks ago
We are seeking a Medical Adjudication Specialist to fill a key role in our claims adjudication department.
- Review medical claims for potential fraud, waste, or abuse.
- Investigate questionable claims by collaborating with medical providers and internal stakeholders.
- Apply clinical expertise to support fair and consistent decisions.
- Negotiate charges with service providers.
- Challenge inflated or non-medically necessary items.
- Communicate with agents, administration teams, and policyholders to explain outcomes.
Requirements:
- 3-5 years of experience in Clinical work in Singapore.
- Strong understanding of surgical codes.
- Excellent analytical thinking and problem-solving skills.
Benefits of this Role:
- Meaningful work as part of a dynamic team.
- Opportunities for career growth and professional development.
- A supportive work environment that values teamwork and collaboration.
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