Medical Claims Investigator

7 days ago

Singapore beBeeClaims Full time $60,000 - $100,000

Claims Examiner Job Summary

As a Claims Examiner, you will play a key role in ensuring the accuracy and efficiency of our claims processes. You will work closely with internal stakeholders to develop and implement new and improved processes to improve overall claims experience.

Job Responsibilities:

  • Provide timely and accurate adjudication of claims, validation, pre-authorisation of applications and LOG issuance to meet operational and SLA targets.
  • Conduct regular review of current claims processes and collaborate with internal stakeholders on developing new and improved processes to enhance efficiency and overall claims experience.
  • Manage escalations and stakeholder relations effectively.
  • Be a champion for change and provide ongoing training and development for effective claims management.
  • Liaise with Insurance Companies to verify exceptions and resolve any complaints.
  • Conduct analysis, prepare periodic reports, and present findings when required.

Requirements:

  • Strong technical understanding of the claims process for medical claims, preferably in a Third-Party Administrator/Managed Healthcare environment.
  • Highly developed interpersonal skills.
  • Excellent organisational skills and exceptional eye for details.
  • Passionate about driving change to improve business outcomes.
  • Exceptional communication skills and stakeholder management skills.

Key Skills:

  • Management Skills
  • Claims Management
  • Ability To Work Independently
  • Legislation
  • Interpersonal Skills
  • Healthcare
  • Written Communications
  • Windows
  • Communication Skills
  • Human Resources
  • Stakeholder Management

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