Team Lead, Outpatient Claims


Claims Processing




The role we are hiring for

We are seeking a Claims Outpatient, Team Lead who will ensure claims are assessed according to Policy’s terms & benefits and are settled within the agreed turnaround time. You will have 3-5 years of experience in processing the claim, the skillset of understanding different insurance products, and leading a team and handling escalations.

The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration and the ability to deal with ambiguity especially in a start-up environment.

A summary of the key responsibilities and requirements are as follows:


Key Responsibilities

  • Manage end-to-end claim process and ensure all claims submitted by the team adheres to guidelines and procedures.
  • Obtain in-depth knowledge of insurance and claim management practices.
  • Assist to resolve complex claims, conduct investigation and negotiate for claims settlements.
  • Attend queries from both internal & external stakeholders and handle complaints.
  • Provide training and guidance to new or junior staff.
  • To ensure strict adherence to company Standard Operating Procedures.
  • Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks especially in Personal Data Protection Act.
  • Participate in any ad-hoc project(s) or duties when required.


Professional Experience/Qualifications

  • Diploma/Degree in relevant discipline with 3 to 5 years of relevant working experience in claims processing
  • Insurance Professional and Health claims experience preferred
  • Certification in Health Insurance (HI) is preferred
  • Unquestioned integrity and high standards in the work you do
  • Comfortable with ambiguity – we are a fast-growing business and there’s always unchartered territories, which is part of the fun. You should be comfortable with it and understand that not everything is 100% defined all the time.
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