Senior Claims Assessor

5 days ago

Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

Job Description Summary

In this role in the PRUShield Claims team (PSC), you will assist the Team Lead of the Inpatient Team to oversee the daily BAU operations, including Pre-authorisation,and High-Net-Worth claims. You will be required to review complex claim and appeal.
You must adhere to the SLA and KPI. You have to ensure the delivery of claims services are aligning with our Claims Promise. You are expected to support BAU claim processing and work. In the course of your work, you will need to liaise with internal stakeholders from other departments, example the Technical team, POS and Underwriting team specifically. At times, you will also be required to liaise with the Financial Consultants, medical institutions, doctors and CPF Board.
You must ensure that within the course of your work, you are at all times compliant with internal policy and regulatory requirements well as our SOP.

This role requires you to be accountable and responsible for the following:

- Timely BAU processing within the SLA
- Manage the processing of High-Net-Worth claims and to oversee Pre-authorisation
- Oversee and take the necessary steps to manage suspicious claims and investigation, including claims costs management.
- Manage communications, queries, feedback, and complaints on PRUShield claims from internal and external customers. This includes the review of appeals and ex-gratia considerations.
- Work closely with the internal stakeholders, including managing the complaints raised by customers and/or our Financial Consultants. This includes any disputes that are escalated to external dispute resolution channels, litigations eg. FIDReC, MOH etc.

Who we are looking for:

- Excellent communication, interpersonal and problem-solving skills
- Has the ability to think out of the box, evaluate and reach an appropriate decision
- Customer-centric and empathetic
- Able to work under intense pressure and tight timeline
- Accountable, self-motivated, and able to work independently
- Good product knowledge and able to comprehend proficiently the intent and spirit of the policy coverage while aligning to the terms and conditions of the policy provisions
- Excellent skills and competencies in claims adjudication
- Innovative
- Team player and has excellent leadership skill
- Ability to build and maintain trusted relationship with internal and external customers, especially with our distribution force
- Ability to guide and support the team through business changes, and maintain positive morale with the team

Working Experience
- With past para-medical experience will be an added advantage
- At least 6 years of experience in medical claims operations

Professional Qualifications
- HI, LOMA certified or its equivalent

Education
- Degree in any discipline

Language
- Strong command of English (oral and written)

  • Senior Claims Assessor

    7 days ago

    Singapore Prudential Assurance Company Singapore Full time

    Join to apply for the Senior Claims Assessor role at Prudential Assurance Company Singapore Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a...

  • Senior Claims Assessor

    2 days ago

    Singapore Prudential Assurance Company Singapore Full time

    Join to apply for the Senior Claims Assessor role at Prudential Assurance Company Singapore Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform...

  • Senior Claims Assessor

    7 days ago

    Singapore Prudential Hong Kong Limited Full time

    Senior Claims Assessor page is loaded## Senior Claims Assessorlocations: Singaporetime type: Full timeposted on: Posted Todayjob requisition id: Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our...

  • Senior Claims Assessor

    2 days ago

    Singapore Prudential Hong Kong Limited Full time

    Senior Claims Assessor page is loaded## Senior Claims Assessorlocations: Singaporetime type: Full timeposted on: Posted Todayjob requisition id: Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our...

  • Senior Claims Assessor

    7 days ago

    Central Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    **Location** - Singapore, Central Singapore**Job Type** - Permanent**Salary** - $4,000 - $6,000 Per Month**Date Posted** - 1 day agoAdditional Details **Job ID** - 117845**Job Views** - 1Roles & Responsibilities - Job Profile Summary: - In this role, you will report into the Team Lead managing PruShield Inpatient claims, including eFiled and non-eFiled...

  • Claims Assessor

    2 weeks ago

    Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    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...

  • Claims Assessor

    7 days ago

    Central Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    **Location** - Singapore, Central Singapore**Job Type** - Full Time**Salary** - $3,500 - $4,500 Per Month**Date Posted** - 1 day agoAdditional Details **Job ID** - 116580**Job Views** - 1Roles & Responsibilities **Job Profile Summary**: In this role, you will be involved in both Claims Assessment and Pre-authorisation. Claims Assessment: You will review,...

  • Senior Claims Assessor

    2 days ago

    Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    Job Profile Summary: 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...

  • Senior Claims Assessor

    2 weeks ago

    Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    Job Profile Summary: 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 the Team Lead of the PSC team and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirements. **Job...

  • Senior Claims Assessor

    2 weeks ago

    Singapore PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED Full time

    **Job Description**: - Adjudicate Shield and Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time). - Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms. - Review workflow and claims processes to identify areas of...