Job Description
Are you passionate about making a meaningful impact in the healthcare insurance space Join us as a Medical Claims Associate, where you'll play a vital role in ensuring our policyholders receive timely and accurate support when they need it most.
As part of our dynamic Health Claims team, you'll not only assess medical claims under our health plansyou'll also be empowered to contribute to service excellence initiatives and exciting projects that enhance the overall claims experience. This is more than just a job; it's a career path that builds deep expertise in claims assessment and customer care.
1. Assess Medical Claims
Provide accurate and timely assessment of medical claims, ensuring all data entry, benefit mapping, and claim tagging are completed in line with required service standards. Handle medical claims assessment and maintain high accuracy.
2. OCR Approval
Act as the checker for the OCR correction team, reviewing and approving OCR processed claims to ensure accuracy and compliance.
3. Engage with Stakeholders
Liaise professionally with medical institutions and policyholders to clarify outstanding requirements and ensure smooth claims processing.
4. Customer & Business Partner Relations
Provide excellent service and strengthen relationships with customers and distribution channels through responsive and empathetic support.
5. Handle escalated claims enquiries
Attend to claims-related queries with clarity, care, and professionalism.
6. Ad-hoc Projects
Undertake any other ad-hoc projects as assigned by your supervisor.
7. Ensure Compliance
Adhere to internal policies and external regulatory requirements to maintain integrity and trust in our claims operations.
Take accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks;
Maintain awareness of industry trends on regulatory compliance, emerging threats and appropriate steps to mitigate the risks; and
Highlight any potential concerns/risks and proactively shares best risk management practices.
