The incumbent will lead in establishing the patient counselling department including managing health claim assessment and handle administrative duties.
In addition, this role will also work with the senior management in implementing the accounting and administrative functions of the group.
Financial counselling
Understand claims policies and preauthorisation procedures of participating panel insurers.
Establish workflow for consumers and internal staffs in preauthorisation of Guarantee of Payment (GOP).
Implement application architectural specifications for internal staff (using Vlookup)
Review existing processes and implement initiatives for efficient processes.
Correspond with insurers for renewal of contracts or new sign on.
Communicate effectively with third party insurers, external stakeholders (eg. CPF board or hospitals) for claims resolution
Respond within service level agreement to ensure timely approval of GOPs.
Financial Administration
Submit E-CLAIMS through Mediclaim portal in accordance to Medisave regulatory requirements.
Ensure all claims comply with MOH and CPF requirements.
Check and ensure claims payment from various institutions are tallied with no discrepancies
Fill and organize all related documents, ensure accuracy and done in a timely manner
Be abreast with industry changes on regulatory compliance, fee changes and updates on submission portals.
Undertake any duties as assigned by Senior management
Requirements
- Diploma or Degree in any discipline
- 1 to 2 years of experience in insurance claims handling or related fields
- Insurance industry knowledge and certificates (e.g. Certificate in Health Insurance)
- Proficient with Microsoft excel (Vlookup)
- Is a team player
- Attention to details; strong analytical, organisational and time management skills
