Claims Assessor

2 weeks ago

Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

In this role, you will review, assess and approve shield claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, PruShield Claims and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirements.

Job Description (also includes pre-authorisation):

- Claim adjudication of Shield claims within service turnaround time and compliance with SOP and internal guidelines.
- Ensure output of assessment is accurate and compliant with internal policy and regulatory requirements.
- Attend to claims investigations (based on claims guidelines), service recovery and enquiry escalated from customer contact points
- Send and attend to clarification with hospitals and clinics
- Involve in projects assigned by supervisor (ad hoc) Provide quality customer service including interacting with Financial Consultants, customers when issues are escalated via customer contact points,
- Provide timely response to complaints
- Review appeals arising from rejected claims

Who are we looking for:
Competencies & Personal Traits
- Strong command of the English language (spoken and written)
- Familiarity with human anatomy, general diseases and disease management
- Detail-oriented and meticulous
- Exhibits collaborative and innovative mind-set
- Possesses good initiative and strong problem-solving skills
- Able to work in a fast-paced environment and under tight pressure
- Accountable and able to deliver work requirement within stipulated timelines Friendly and able to communicate and collaborate with Panel Hospitals/ Clinics with tact and timeliness
- Good negotiation skills
- Familiar with Microsoft Word and Excel

Working Experience
- At least 2 years of experience as a Life & Health claims assessor
- Experience in Shield Claims processing and pre-authorisation of claims are highly preferred Attained professional qualifications, eg: Health Insurance, LOMA, FLMI (Fellow, Life Management Institute etc.)

Education
- Degree in Biology & Life Sciences
- Diploma in Nursing Create Job Requisition

Language
- Strong in English (both written and spoken)

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