AVP MEDICAL CLAIM

• Provide accurate and timely assessment of medical claims within the required service standards and ensure that claims are paid accurately and promptly
• Handle claim investigation
• Mentor and guide junior staff to build claim assessment competency, medical knowledge and communication skills through coaching and training.
• Build collaborative relationships with and ensure that claims are well managed for both internal and external key stakeholders (i.e policyholders, beneficiaries, distribution servicing representatives, medical institutions) to achieve claims business objectives
• Review claims processes and participate in process improvement projects, initiatives and system enhancement for the department, including establish claims best practices
• Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
• Maintains awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company.
• Highlights any potential concerns /risks and proactively shares best risk management practices.

Requirements

• Diploma in Nursing or Professional Insurance Certificate with at least 8 years of relevant accident and health claims experience.
• Mid-level claims assessors who are looking for greater challenges and greater exposures
• Strong knowledge on integrated shield claim processes and industry initiatives in managing medical claim cost
• Strong knowledge on inpatient claims and integrated shield claim processes and industry initiatives in managing medical claim cost
• Strong leadership and people management skills
• Strong analytical, business writing and communication skills
• Good medical knowledge and ability to explain medical conditions in insurance context

Interested applicant please email  your detailed resume to career@abercare.sg or contact us at +65 6721 9231.