Group Insurance, Claims Executive/Senior Executive

Group Insurance, Claims Executive/Senior Executive

Purpose of the Role

• Assess and process local and overseas claims from both hardcopy and electronic claim submissions. 
• Handle follow-ups on claims with unsuccessful bank transfers. 
• 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 settlements.
• Manage and reply emails for common mailboxes.
• Following up with clinics/ hospital for enquiries on billing details.
• Other assigned tasks, for example report preparations, finance and payment activities, etc. 

Key Responsibilities

• Assess claims using Group Insurance core systems, other business systems including vendors’ systems.
• Communicate claims decision clearly.
• Arrive at customer orientated outcomes by working with key stakeholders.
• Engage key stakeholders when handling appeal cases or complex cases. 

Experience

• Familiar with group insurance products like Group Term Life, Group Personal Accident, Group Disability Income, Group Critical Illness, Group Hospitalisation & Surgical and Group Outpatient
• Completion of Health Insurance Certificate, M5 & M9 is preferred

Company Reg No.: 201131609D, Licence No.: 11C4684, EA Reg no: R21100351