Ministry Medical Group jobs

• Review and assess local and overseas medical and non-medical claims within policy terms and conditions and claims authority limit within stipulated turnaround time.

• Review and approve Pre-Authorisation/LOG requests within policy terms and conditions and MOH benchmark.

• Coordinate with medical providers, policyholders, and other stakeholders for additional information when necessary.

• Handle follow-ups on claims with unsuccessful bank transfers and CPF failures, such as voiding claims, creating refund entry and reprocessing of claims.

• Request and follow-up on the creation of insured members and medical service providers for affected claims.

• Prepare claim settlement letters and scan claims documents to shared drive.

• Update Statements of Accounts relating to hospital bills/claim settlements.

• Communicating with policyholders, healthcare providers, intermediaries and internal teams to resolve issues and clarify claim details.

• Address claim disputes or queries from clients or intermediaries in a professional and efficient manner.

• Following up with clinics/ hospital for enquiries on billing details.

• Following up on monthly outstanding receivables, including but not limited to requesting refund for overpayments from relevant parties such as claimants, hospitals, insurers and CPF Board.

• Prepare meeting minutes and reports, including but not limited to daily claims report, statistical analysis and trends.

• Handle finance and payment activities including but not limited to voiding claims, creating refund entries, raising and approving receipt voucher cancellations and cheque cancellations.

• Participate in projects and enhancement in claims system improvement including but not limited to data collection, UAT testing and suggest improvements to the claims assessment process to increase efficiency and accuracy.

• Identify potential fraud or inconsistencies and report them to management.

• Other assigned tasks.

• Assess claims using Group Insurance core systems, other business systems including vendors’ systems.

• Communicate claims decision clearly.

• Response to queries in a timely manner.

• Manage his/her workload to achieve required service levels.

• Arrive at customer orientated outcomes by working with key stakeholders.

• Participate in activities that improve processes, productivity, and services and solutions to customers.

• Engage key stakeholders when handling appeal cases or complex cases.

• Establish good working relationship with intermediaries and clients

• Familiar with group insurance products like Group Term Life, Group Personal Accident, Group Disability Income, Group Critical Illness, Group Hospitalisation & Surgical and Group Outpatient

• Group Claims Experience of at least 3 years, Good Oral & Written Communication.

• He/she is expected to be a good problem solver.

• A good team player with good interpersonal skills and highly energetic.

• An individual who is results oriented.

• An individual with an open and growth mindset, and willing to step up beyond the call-of-duty.

• Completion of Health Insurance Certificate, M5 & M9 is preferred.

• Diploma or Degree

• Good Microsoft Office Skills (e.g. Word, Excel, Powerpoint)

Singapore, Singapore, Singapore