Employee Benefits Claims

Job Description:

• AdjudicateGroupMajorClaims (DeathTPDCritical Illness Disability Terminal Illnessetc) and Group Medical Claims (Hospital & Surgical Major Medical Outpatient Specialist Outpatient Clinical Dentaletc)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.

• Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.

• Manage working relation with external parties Central Provident Fund Board (CPFB)medical institutionsTPAsetc.

• Manage investigation of claims by working with claims adjusters legal advisors medical institutions claimants financial consultants and other insurers todetermineclaims decision and payment.

• Manage enquiries service recovery complaints and appeal arising from claims.

• Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.

• Any other ad-hocassignmentassigned.

Who we are looking for:

Competencies & Personal Traits

• Detail-oriented with a commitment to accuracy and quality.

• Innovative and resilient with a strong eye for detail

• Excellent communication skills in English both written and verbal

• Conflict resolution and relationship management skills

• Customer-centric with ability to work under pressure

• Self-motivated and independent

• Team player

Working Experience

• 2 to 3 years of working experience inboth life andmedical claims processing

Education

• Diploma or Degree

Language

• English