Team Lead, Outpatient Claims
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:
- 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.
- 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.