Senior Claims Specialist (Accident & Health, Insurance, Up to $7k) (ID:655316)
Full-time
Senior Executive
3 weeks ago
Job Description
Claims Service
Work within local and regional on operating processes and claim handling procedures to ensure that quality claim ser..
Job Description
Claims Service
- Work within local and regional on operating processes and claim handling procedures to ensure that quality claim service is rendered to all customers in accordance with Claims Philosophy.
- Effectively assist Consumer Claims Lead to manage A&H claims underwritten or reported in Singapore against policy terms and conditions, claims best practices guidelines, statutory and company guidelines, local operating procedures and claims management guidelines.
- Evaluate the cost effectiveness of claims handling procedures. Recommend improvements to reach optimum performance and service standards.
- Attend to claim enquiries and feedback, maintain positive relationship with all customers, brokers, service providers etc,
- Claims costs containment and loss dollar management – accurate interpretation of policy coverage, close liaisons with underwriters and internal colleagues to manage accounts and on risk improvement and suspicious claims, claims data and loss trend analysis. Contribute to discussions with business units for products developments and loss control.
- Ensure that Consumer Claims Lead and appropriate Underwriters, as required, are made aware on a timely basis of specific claims issues or trends which may impact underwriting decisions.
- Use external resources in accordance with the guidelines and philosophies. This includes the engagement of appropriate service providers where required and management of such providers and cases towards the timely and effective resolution of the matter.
Claims Quality
- Manage and handle claims to finality within designated Settlement Authority and Claims Management Guidelines, including timely action, appropriate investigation, regular case reviews and proper evaluation are taken in all claims.
- Ensure that loss reserves are set and maintained in accordance with guidelines, timely updates of claims data made into systems and correctness of systems and file records,
- Comply with company quality review program guidelines and ensure corrective action is complemented as necessary.
- Complete Reserve Reconciliation and Advocacy reviews in accordance with guidelines.
Expense Management
- Provide input to, and in association with Consumer Claims Lead to monitor and control department operating budget (UCE) by ensuring departmental controls are prudently applied and interests are always protected.
- Manage and monitor Allocated Claim Expense (ACE) and adhere to all controls and guidelines.
Others
- Maximize recoveries from insurers, salvage dispositions, subrogation or other recovery proceedings through close monitoring. Ensure timely advices, relevant supporting documents and responses to enquiries are provided to coinsurers / reinsurers to settle their share promptly.
- Provide and/or assist with the provision of statistical analysis and operational reports.
- As required, to provide Claims Representation/Support including visitations, meetings, presentations, etc. with Underwriters and/or Business Unit.
- As required, assist in claims related projects including UAT etc, and other projects/assignments or tasks, as assigned.
- To meet or exceed the expectations/objectives set on the individual’s and the Team’s yearly goal setting.
Requirements:
- Diploma / Degree / Professional certificates in the relevant discipline
- Preferably with at least 2 - 3 years of relevant experience in handling a variety of A&H claims
- Advanced expertise and knowledge in A&H claims handling.
- Excellent communication and internal personal skills. Ability to effectively manage all internal and external stakeholders.
- Able to lead a small team
Interested candidates who wish to apply for the advertised position, please click on “Apply”. We regret that only shortlisted candidates will be notified.
EA License No.: 01C4394 (PERSOLKELLY Singapore PTE LTD)
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