Claims Operations Transformation Professional

2 days ago

Singapore beBeeTransformation Full time
Claims Operations Excellence

We are seeking an experienced professional to drive transformative change in our claims operations. This role will oversee the development and implementation of a comprehensive strategy to enhance claims processing efficiency, reduce manual interventions, and improve decision accuracy.

Key Responsibilities:

  • Develop and execute a strategic plan to optimize claims processing through organizational redesign, business model and process redesign, automation, and technology adoption.
  • Collaborate with cross-functional teams to ensure seamless claims operations, stakeholder engagement, and effective communication.
  • Lead initiatives to re-engineer end-to-end claims processes, focusing on operational efficiency, cost reduction, and quality assurance.
  • Implement advanced solutions for fraud detection, waste minimization, and claims adjudication using AI-driven tools and analytics capabilities.
  • Oversee the integration of predictive models and advanced analytics tools to streamline claims workflows and evaluate emerging technologies.
Requirements
  • Education: Bachelor's degree in Business Administration, Healthcare Management, or a related field; MBA or advanced degree preferred.
  • Experience: 15+ years of experience in medical claims operations, healthcare insurance, or related fields; proven track record of leading claims transformation or process improvement initiatives.
  • Technical Skills: Familiarity with claims adjudication platform design frameworks, AI-driven FWA detection tools, and analytics capabilities.
  • Leadership: Exceptional leadership, strategy, and change management skills.
  • Communication: Strong communication and stakeholder management abilities to influence and drive cross-functional collaboration.
Preferred Skills
  • Experience with SaaS-based claims solutions and digital health platforms.
  • Knowledge of regulatory compliance and standards in healthcare insurance.
  • Clinical background or understanding of medical terminology is a plus.
About the Opportunity

This is a unique chance to make a meaningful impact in the healthcare industry. As a key member of our team, you will be responsible for driving innovation, improving processes, and delivering exceptional results.

What You Will Gain:

  • Opportunity to work with a dynamic team of professionals who share your passion for excellence.
  • Chance to develop and implement cutting-edge strategies that drive business growth and improvement.
  • Experience working with advanced analytics tools and AI-driven solutions.
  • Collaborative work environment that fosters open communication and teamwork.
Join Our Team

At [Company Name], we believe in empowering every one of our people to find their better - in the work they do, the career they build, the life they live, and the difference they make. We encourage and enable our people to act with clarity, courage, and humanity in service of our Purpose.

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