Claims Consultant

Job Profile Summary:
In this role, you will review, assess and approve shield claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, PruShield Claims and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirement and meet service objectives.

Job Description:
. Review, assess and approve shield claims within service turnaround time.
. Ensure output is accurate and compliant to internal policy and regulatory requirement and meet service objectives
. Manage claims investigation
. Attend to service recovery, complaint, appeal, enquiry
. Coach, supervise and guide subordinates in providing accurate and prompt services to advisers and claimants
. Conduct medical claims technical workshops for agency force
. Identify process shortcomings and implement improvement
. Plan and organize resource and headcount for business needs
. Manage working relation with external parties - CPFB, auditor, regulator, agency leaders, bancassurance partners

Who we are looking for:
Competencies & Personal Traits
. Team player, mature, with excellent leadership quality.
. Good knowledge of hospital admission, discharge and claims processes.
. Good medical knowledge and claims settlement procedure.

Working Experience
. Former medical practitioner experience as doctor, nurse, health therapist or healthcare provider will be an added advantage
. At least 5 - 7 years of experience in managing claims operations

Professional Qualifications
. LOMA certified or equivalent

Education
. Degree with good credit in English and Mathematics