Claims Analyst (Group Insurance / Medical Claims) 1 Year Contract #NKC
Summary
The Claims Analyst will review and assess medical and non-medical insurance claims, manage pre-authorization requests, and process settlements. The role involves coordinating with healthcare providers and policyholders while supporting system enhancements and reporting.
Jobs Responsibilities
- Review and assess local and overseas medical and non medical insurance claims in accordance with policy terms, authority limits and established turnaround times.
- Review Pre Authorisation and Letter of Guarantee requests; assess eligibility based on policy coverage and applicable medical benchmarks.
- Liaise with policyholders, healthcare providers, intermediaries and internal teams to obtain information, resolve claim queries and handle disputes.
- Process claim settlements and payment related activities including refunds, unsuccessful transfers, CPF related cases, receipt cancellations and claim reprocessing.
- Monitor outstanding receivables and overpayments; coordinate recovery or refunds with claimants, hospitals, insurers and relevant parties.
- Prepare claims reports and analysis; support UAT, system enhancements and process improvements while identifying and escalating potential fraud or claim inconsistencies.
Interested applicants may email resume to kellychooi@recruitexpress.com.sg
Chooi Kelly (CEI Registration No: R25136207)
Recruit Express Pte Ltd (EA: 99C4599)
We regret only shortlisted candidates will be contacted