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Medical Claims MGR/ AVP in Singapore at Great Eastern

Date Posted: 7/30/2018

Job Snapshot

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Job Description

Job ID: 000197

The Job


  • To process medical claim accurately and promptly to ensure that the department’s KPIs are met.
  • To handle claim investigation and claims appeals (if applicable).
  • To ensure periodic review of pending claims and to resolve as many pending claims as possible monthly.
  • To handle customer care issues and ensure timely and proper resolution.
  • Other duties as assigned. Example:
  • Review and finalise pending claims within reasonable time.
  • Provide timely response to claims related queries with proper resolution.
  • Department risk officer for risk related matters.
  • Work with key stakeholders on campaign, product development, claims expenses, etc.
  • To ensure that assigned projects are completed by the due date.
  • To ensure that all claims are processed promptly and accurately.
  • To ensure excellent customer service.
  • To ensure that Key Performance Indicators are met.
  • To attend to phone, fax and email enquiries pertaining to pending claims.
  • To assist Claims Staff at times when they are unable to answer certain types of enquiries.
  • To assist claims staff at times when they need an opinion on claims assessment.
  • Any other duties as required by Head of Department or Operations Section Head or Team Leader.

Job Requirements

Our Requirements

Claims assessment competency and skills

  • To achieve 90% of claims processed within 10 working days (from last document date till letter issuance date)
  • For e-filed claim, to achieve 90% and 95% processed within 7 working days and 28 days respectively and a median of 0 day.

Management of Aging claim

  • To call for pending requirements within 14 working days from notification of claim or date of receipt of claim document (including medical reports)
  • To send reminders on outstanding requirements and ensure that all pending claims are resolved promptly

Operational Efficiency & Quality enhancement

  • Ensure error rate ≤2% of total claim processed
  • Achieve pass rate for audit
  • Review, identify and implement process and service improvements for the department

Customer Service Excellence

  • Attend/ reply to emails and voicemails promptly and correctly
  • To provide a response on claims queries within 3 working days from escalation by CS touch-points
  • Handle customer care issues to ensure proper and timely closure
  • Conduct training to agency force whenever required

To all recruitment agencies: Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.