Claims Assessor
2 weeks ago
Review, assess and approve shield claims within service turnaround time. Ensure the output is accurate and compliant to internal policy and regulatory requirements.
- Attend to claims investigations, service recovery and enquiry
- Attend to medical clarification with hospitals and clinics
- Involve in projects assigned by supervisor
- Provides quality customer service including interacting with customers, answering customer enquiries and effectively handling customer complaints
- Review the rules of Straight through (STP) process of PP claim from web, data capture tools, MedLM etc.
- Involve in UAT testing i.e. involved in the Quality check of the cases adjudicated by the MedLM vis-à-vis the cases finalised by claim assessors
- Liaise with the project team of MedLM to ensure smooth delivery of the MedLM system
**Who we are looking for**:
**Competencies & Personal Traits**
- Strong command of the English language (spoken and written)
- Familiarity with human anatomy, general diseases and disease management
**Working Experience**
- 4 years of experience as a Life & Health claims assessor
**Professional Qualifications**
- OMA, FLMI (Fellow, Life Management Institute)
**Education**
- Degree holder of biology & life sciences discipline
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