Process Improvement and Transformation Specialist
4 days ago
Role Purpose
The incumbent will work under the direction of the Lead, Process Improvement and Transformation, supporting the strategic vision by identifying and implementing operational improvements, system enhancements, and best practices within the PRUShield Claims Team. The individual will collaborate 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 ability to foster a culture of continuous improvement within the division.
Organisation Context
This role reports directly to the Lead, Process Improvement and Transformation and will be working closely with different teams to improve process and efficiency for the division. Key initiatives include identifying inefficiencies and proposing solutions to enhance systems, eliminate inefficiencies, investigate and review escalations by claim users, and propose short-term/long-term fixes for the team.
Job Description
Review all system related feedback/escalation, from claim assessors and servicing team
Work with tech team/Business Analyst to investigate issues and identify root cause, interim solution, and permanent fix.
Liaise with claim assessors/servicing team to raise Remedyforce tickets.
Keep track of all open tickets and send regular reminders to technical team on open items.
Prepare and raise all necessary forms for system patching and updating tables.
Review and sign off all system patching and table lifting/updates.
Work with respective claims team's representative to gather requirements and feedbacks.
Work with Team Lead on issues raised by claims users and prioritise requests.
Review and sign off user story.
Work with different tech teams to identify the effort required for each phase of enhancements including testing and set deployment timeline targets.
Support QA team with test plan creation, review, and sign off.
Review all test results to ensure output consistency with requirements before signoff.
Sanction creation for all new staff.
Provide support for 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.
Maintain data in LifeAsia/Jireh system - panel/non-panel/Extended panel list
Ensure timely updates of data provided by MOH in system – Clinics, Cancer Drug List, TOSP/ICD Codes
Who We Are Looking For:
Competencies & Personal Traits
System related knowledge is an advantage
Able to work closely with different teams
Ability to work in a fast-paced environment with tight deadlines
Working Experience
Minimum 5 years of experience, must have experience in health/shield claims
Education
Bachelor’s Degree
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