Claims Assessor

3 days ago

Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

**Job Description**:

- 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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