- Review and assess inpatient and outpatient health insurance claims, including medical, surgical, and hospital claims.
- Ensure claims are in line with policy coverage, terms, and conditions, and compliance with all relevant regulations and guidelines.
- Ensure timely conclusion of claim settlements within agreed turnaround times.
- Investigate complex cases or client complaints, providing effective solutions.
- Liaise with healthcare providers, policyholders, and internal teams to gather necessary information for claims evaluation.
- Assist in identifying fraudulent claims or unusual patterns and escalate where necessary.
- Collaborate with team members and supervisors to improve processes and ensure continuous quality improvement.
- Maintain accurate records and documentation of all claims assessments and decision.
Requirements
- Minimally GCE O level and above
- prior clinic claims experience would be preferred
- able to start work on short notice
Interested and qualified candidates, please send in your application to [email protected]
Ivy Yong Shi Mei
R2198995
Recruit Express Pte Ltd 99C4599
