Assess and adjudicate life and medical insurance claims within authority limits. Investigate claim validity by reviewing medical evidence, policy documents, hospital bills, and investigation findings. Escalate complex claims, resolve enquiries, manage appeals and complaints, and ensure fair, consistent outcomes. Support process improvement and customer service initiatives while maintaining effective stakeholder communication and detailed claims documentation.
Job Description
- Assess and adjudicate Life and Medical claims within authority limits in accordance with policy terms and conditions.
- Conduct claims investigations where necessary, including reviewing medical evidence, policy documentation, and other relevant information to determine claim validity.
- Identify, investigate, and escalate complex claims to the Claims Manager for further review.
- Handle escalation enquiries from policyholders, intermediaries, healthcare providers, and internal stakeholders, providing timely and professional resolutions.
- Handle appeals, complaints, and disputed claims, ensuring fair and consistent outcomes while maintaining a positive customer experience.
- Support continuous improvement initiatives and contribute to enhancing claims processes and customer service standards.
- Perform any other duties as assigned by the Claims Manager.
Job Specification
- Degree in any discipline.
- At least 3 years of experience in Life or Medical Claims handling.
- Certification in Health Insurance and General Insurance (BCP, PGI & ComGI) and Life Insurance qualifications.
- Ability to review and interpret medical reports, hospital bills, policy contract provisions, and investigation findings.
- Excellent communication and interpersonal skills.
- Good customer service, complaint-handling, and stakeholder management skills.
- Strong analytical, investigative, organizational, and time management skills, with attention to detail.
Income Insurance Singapore, Singapore, SGP Office
75 Bras Basah Road, Singapore, Singapore, Singapore, 189557
Income Insurance Singapore Office
Singapore
Income Insurance Singapore, Singapore, SGP Office
1 Paya Lebar Link, #07-01 PLQ 1 Paya Lebar Quarter, Singapore, Singapore, Singapore, 408533
Income Insurance Singapore, Singapore, SGP Office
2 Tampines Central 6, #01-01 NTUC Income Tampines Point, Singapore, Singapore, Singapore, 529483
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