Executive, IS Opt Claims

The Life and Health Operations (LHO) department plays a pivotal role in ensuring we provide our customers with affordable and comprehensive life and health products, with efficient processes to allow optimal service to our customers. As part of the team dedicated to manage Income. Shield claim assessment, your key responsibilities include: Processing and assessing all types of Income.

Shield claims, with a specific focus on outpatient claims Assess policy liability, investigate claims and determine the claim amount payable based on Income's policy cover and management guidelines Compile, analyse and submit Claims reports as and when required To also prepare report on claims cases to be escalated to management and present cases at committee meetings Manage enquiries and complaints from claimants Liaison with intermediaries, hospitals and various external parties Undertake any other duties or projects as assigned by the Supervisor or Head of Section Qualification At least obtained a Diploma or Degree in any field Certified in Health Insurance (HI) Have at least 2 years of individual claims experience.

Experience in Shield claim processing and assessment will be an advantage Ability to professionally manage insurance claims enquiry and negotiations Good analytical skills, meticulous with a flair for numbers to handle complex computations Team player and self-motivated