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Claims QA Specialist (1 year contract)
PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITEDD01 Cecil, Marina, People’s Park, Raffles Place, SG30+ days ago
Job descriptionStrong command of the English language (spoken and written) Familiarity with human anatomy, general diseases and disease management 4 years of experience as a Life & Health claims assessor OMA, FLMI (Fellow, Life Management Institute) Degree holder of biology & life sciences discipline
Roles & Responsibilities
Job Description :
- Review, assess and approve shield claims within service turnaround time. Ensure the output is accurate and compliant to internal policy and regulatory requirements.
- Attend to claims investigations, service recovery and enquiry
- Attend to medical clarification with hospitals and clinics
- Involve in projects assigned by supervisor
- Provides quality customer service including interacting with customers, answering customer enquiries and effectively handling customer complaints
- Review the rules of Straight through (STP) process of PP claim from web, data capture tools, MedLM etc.
- Involve in UAT testing i.e. involved in the Quality check of the cases adjudicated by the MedLM vis-à-vis the cases finalised by claim assessors
- Liaise with the project team of MedLM to ensure smooth delivery of the MedLM system
Who we are looking for :
Competencies & Personal Traits
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Professional Qualifications
Education
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Hospitals
Service Recovery
Assessor
Biology
Regulatory Requirements
Customer Service
Life Sciences
Disease Management
Anatomy
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Specialist Contract • D01 Cecil, Marina, People’s Park, Raffles Place, SG