Manager, Medical Claims - Singapore - Doctor Anywhere

Doctor Anywhere

Verified Company

Singapore

2 weeks ago

Posted by:

Wei Jie

beBee Recruiter

Description

About the team
Doctor Anywhere's Operations team is a crucial part of the company.

We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible.

We make sure that our customers remain our top priority.

The role we are hiring for

We are seeking a
Manager, Medical Claims who is responsible for leading the claims team in ensuring accurate and timely administration of claims.

This role reports directly to the Senior Manager, Claims.

A summary of the key responsibilities and requirements are as follows:

Responsibilities

Demonstrate thorough understanding of health technical claims assessment and processes
Ensure accurate and timely assessment of health claims within the required service standards
Assist Head of Claims to monitor and manage timely closure of outstanding claims
Handle claim enquiries, service recovery, complaints, appeals and other customer care matters
Perform claim peer review inspection for claims exceeding assessor's authority limit
Review and prepare claims SLA reporting as per stipulated timeline
Conduct health technical claims assessment and training for new joiners
Manage work relation with external parties such as medical institutions, clients, etc
Manage key internal stakeholders such as claims, network management teams etc. to ensure all service level agreements are met
Participate in operation efficiency and A.I. driven projects to bring efficiency to claims processes
Review onboarding process for new accounts i.e acts as Subject Matter Expert (SME) for claims and identify any gaps relevant to claims
Manage other adhoc projects as assigned from timetotime

Requirements:

Degree or Diploma in any discipline with at least 8 years of relevant Health claims assessment experience
Strong background in Medical claim, specifically technical claims assessment and claims management
Strong policy language skills enabling accurate and consistent policy wording interpretation
Strong knowledge of health ecosystem or operations of medical institutions will be an added advantage
Strong analytical, written and communication skills
Strong critical thinking skills and ability to handle complex computations
Meticulous with a keen eye for details
Customer centric
Ability to work under pressure and manage deadlines
Team player and selfmotivated