Process Optimization and Efficiency Expert
4 days ago
As a Process Optimization and Efficiency Expert, you will be responsible for identifying and implementing operational improvements, system enhancements, and best practices within the PRUShield Claims Team.
The incumbent will work under the direction of the Lead, Process Improvement and Transformation, supporting the strategic vision by collaborating with cross-functional teams to drive transformative initiatives aimed at optimizing workflows, reducing inefficiencies, and enhancing service delivery.
The role requires a proactive approach to problem-solving and the ability to foster a culture of continuous improvement within the division.
Key Responsibilities:
- Collaborate with cross-functional teams to drive transformative initiatives aimed at optimizing workflows, reducing inefficiencies, and enhancing service delivery.
- Identify and implement operational improvements, system enhancements, and best practices within the PRUShield Claims Team.
- Work with tech team/Business Analyst to investigate issues and identify root causes, interim solutions, and permanent fixes.
- Liaise with claim assessors/servicing team to raise Remedyforce tickets.
- Keep track of all open tickets and send regular reminders to the technical team on open items.
- Prepare and raise all necessary forms for system patching and table lifting/updates.
- Review and sign off all system patching and table lifting/updates.
- Work with respective claims team's representatives to gather requirements and feedback.
- Work with Team Lead on identified issues raised by claims users and prioritization of all requests.
- Review and sign off user stories.
- Support QA team on test plan creation, review, and sign off test plans.
- Review all test results to ensure the output is consistent with the requirements before providing signoff.
- Sanction creation for all new staff.
- Provide support on outstanding suspense and hospital recoveries.
- Participate in monthly meetings for each team to gather feedback on system-related issues.
- Provide updates and training to claims team on system-related enhancements.
- Maintenance of data in LifeAsia/Jireh system - panel/non-panel/Extended panel list.
- Ensure timely updates of data provided by MOH in the system – Clinics, Cancer Drug List, TOSP/ICD Codes.
Requirements:
- A minimum of 5 years of experience in health/shield claims.
- System-related knowledge is an advantage.
- Able to work closely with different teams.
- Ability to work in a fast-paced environment with tight deadlines.
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