Prushield Claims Executive
1 week ago
In this role, you will provide dedicated PRUShield Claims administrative services to the various stakeholders within the department and PACS. You must ensure delivery of key service objectives through efficient and effective claims management.
**Job Description**:
The key responsibilities of this role are to provide administrative support to the entire PRUShield Claims team on all matters relating to:
Management of Medical Reports / Clarification to Hospitals and Clinics:
- Sorting of medical reports on daily basis which includes photocopying and backend scanning ensuring all requests from assessors are accounted for by recording all outbound mails
- Generate templated medical reports to private clinics or polyclinics
- Person in-charge to liaise with clinics and hospitals on payment of medical report fees
- Send reminders for outstanding medical reports
Management of incoming and outgoing mails received from Mailroom and registered mails to policyholders and doctors:
- Identify owners of unfamiliar mails
- Checking of documents received without policy numbers indicated and redirecting them to the correct parties
- Management of soft copy claim submissions from Financial Consultants and policyholders and distribution to claim assessors
Processing of cheques received:
- Sorting and recording of cheques received
- Photocopy and send for backend scanning before mailingl distribute cheques to the respective parties
- Liaise with Call Centre on reissuance of cheques and collection of returned documents
- In-charge of retrieval of documents from file room and liaise with Finance Ops on stop-payment and reissuance of cheques
- Sort all e-Faxes which pertain to medical reports, invoice for medical report fee, clarification from clinics etc
Generate CPFADV exception report:
- Keep track of records into the tracking sheet of all CPFADV error cases
- Liaise with medical providers on bank account details (if cases are found under the CPFADV exception report)
- Create bank account details of medical providers based on our standard operating procedure upon
- Receipt of the bank account details to facilitate payment via direct credit thereafter
- Engagement with hospitals and clinics to ensure efficient delivery of medical report requests and billing of medical report fees
- Create policyholder’s bank account details in the system for direct crediting of claim payout
- Compliant with regulatory requirements, corporate guidelines and ethics
- Work closely with Call Centre, Finance Ops and Customer Service to ensure smooth and efficient service delivery to customers within turnaround time
- Other ad-hoc duties as assigned by Team Lead
Additional Job Description:
Who we are looking for:
Competencies & Personal Traits
- Strong command of the English language (spoken and written)
- Good knowledge of Word and Excel
- Able to work under stress and tight timeline
- Team player
Working Experience
- Preferably with past experience in Insurance Industry and Operations Department
Education
- O Level and above
Language
- English
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