Medical Claims Officer

1 week ago

Singapore SPECIALIST WOMEN'S IMAGING (SINGAPORE) PTE. LTD. Full time

**Medical Claims Officer**

You will provide oversee medical claims of patients and provide general administrative support to the department.
- Oversees hospital and doctor's fees billing upon patient's discharge.
- Seek clarifications and liaise with medical institution and policyholders on outstanding requirements
- Promptly process final bills and provide payers with accurate invoices.
- Ensure timely and accurate billing for submission to relevant authorities for Medisave/MediShield claims (where applicable).
- Attend to claims enquiries, check ledger to ensure the accuracy in billing including the Letter of Certification.
- To be familiar with the Medisave/MediShield claims and able to provide update on the claims when asked.
- To monitor and follow up with CPF board and private insurance companies for any pending claims.
- To assist in answering of all queries pertaining to bills and Medisave/MediShield claims.
- To perform any other duties assigned by Supervisor.
- Ensure compliance with internal and external regulatory and legal matters
- Conduct review of pending claim to ensure reserve adequacy and closure of claims in a timely manner
- Where first call resolution is not possible, follow up closely with internal counterparts for required resolution before reverting to the customer.
- Proactively escalate query trends or potential issues to team lead/manager
- Strict adherence to SOPs and perform routine checks/audits within the clinic.
- Assist in coverage of other facilities when required due to lack of manpower.

**Requirements**:

- Diploma with at least 2 years of relevant accident and health claims experience
- Prior experience in medical claims or insurance industry will be an added advantage
- Strong analytical, written and communication skills
- Detail and service-oriented, skilled in effective planning and multitasking.
- Customer-centric and meticulous with the ability to work under pressure
- Displays a positive attitude with a strong eagerness to learn.
- Ability to speak in multiple languages will be beneficial.
- Basic IT knowledge and computer literacy.
- Able to work 44 hours (5.5 days) a week.
- Able to travel down to various clinics across Singapore.
- Comfortable with working independently or in a team with a fast-paced environment.

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