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Claims Ecosystem Specialist
2 weeks ago
Job Overview
">This role is focused on tailoring a claims platform to the Singapore healthcare and insurance ecosystem.
">Key Responsibilities:
">- ">
- Collaborate with stakeholders to validate and adapt the existing platform for Singapore's health insurance context.">
- Lead requirement workshops and capture detailed functional and non-functional requirements across all stages of claims.">
- Map current-state and future-state processes, especially for inpatient and outpatient claims, death and critical illness claims, and crosswalks between ICD-10, TOSP, and benefit entitlements.">
- Analyze gaps between the product's current capabilities and Singapore-specific needs, and work with product and implementation teams to address them.">
- Ensure accurate handling of Singapore-specific constructs such as shield vs top-up logic, enclaves/exclusions, CPF usage, and MOH guidelines.">
- Translate business requirements into clear user stories or functional specifications.">
- Support user acceptance testing (UAT) and act as a trusted liaison between customer teams and internal stakeholders.">
Required Skills and Qualifications:
">The ideal candidate will bring deep understanding of Singapore's healthcare and insurance ecosystem, including Integrated Shield Plans (IPs), Riders/Top-ups, MOH compliance, and CPF / MediSave interactions.
">They will also have 6+ years of experience in business analysis or consulting in the health insurance domain, specifically around claims processes.
">Proven experience in claims platform implementation — ideally for life and health insurance across APAC — is highly valued.
">Familiarity with Singapore's healthcare financing and insurance constructs, including ICD-10 / TOSP code usage and benefit mapping, is essential.
">Strong process documentation and requirement analysis skills are necessary, as well as effective communication and stakeholder management.
">A comfort working with product teams to extend or localize existing features is required.
">Preferred Qualifications:
">Previous engagement with Singapore-based health insurers or TPA systems is an asset.
">Exposure to digital claims transformation projects or automation-led adjudication is desirable.
">Experience working in Agile/Scrum environments is preferred.
">A Bachelor's degree in Business, Healthcare Administration, Information Systems, or related field is necessary.
">What We Offer:
">This is not a greenfield development role; we are implementing a mature claims product and require someone who can confidently validate and refine it for Singapore's unique regulatory and operational landscape.
">Business Analyst, Digital Claims, Health Insurance
">