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- Adjudicate Shield and Accident & Health (A&H) claims 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.
- Review workflow and claims processes to identify areas of improvement and implement enhancement to achieve efficient claims administration.
- 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), regulator, financial consultants, bancassurance partners, medical institutions, etc.
- Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims 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.
- Strong command of the English language (spoken and written)
- Familiarity with human anatomy, general diseases and disease management
- 3 to 4 years of experience as a Life & Health claims assessor
- OMA, FLMI (Fellow, Life Management Institute)
- Degree holder of biology & life sciences discipline
- English
Senior Claims Assessor - Singapore - PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED
Description
Roles & ResponsibilitiesJob Description:
Who we are looking for:
Competencies & Personal Traits
Working Experience
Professional Qualifications
Education
Language
Microsoft Excel
Hospitals
Reinsurance
Investigation
Photos
Service Recovery
Administration
Service Level
Logging
Assessor
Biology
Team Lead
Regulatory Requirements
Life Sciences
Disease Management
Anatomy