Claims Operations Specialist

The Claims Processing & Backend Operations Specialist will handle the end-to-end process of insurance claims, including both reimbursement and pre-approval claims. This role involves coordinating with customers, hospitals, and insurance underwriters to ensure efficient and accurate claims processing.

Responsibilities:

Claims Processing:

• Review and process reimbursement claims submitted by customers.
• Coordinate with customers to collect necessary documents, reports, and invoices.
• Work with insurance underwriters to facilitate claim approvals and reimbursements.
• Ensure timely and accurate processing of claims.
• Pre-Approval Coordination:
  
• Manage pre-approval requests for medical treatments and procedures.
• Liaise with hospitals, clinics, and insurance providers to obtain necessary approvals.
• Maintain records of pre-approval requests and outcomes.
• Backend Operations:
• Maintain and update claims processing systems and databases.
• Generate reports on claims status and performance metrics.
• Assist in resolving any issues or discrepancies related to claims.
• Support continuous improvement initiatives in claims processing.

Qualifications:

• Bachelors degree (preferably in Healthcare Administration, Business, or related field).
• Minimum of 1 year of experience in claims processing or healthcare administration.
• Familiarity with insurance processes and regulations.
• Strong organizational and problem-solving skills.
• Excellent communication and customer service skills.

Preferred Skills:

• Experience in the healthcare industry.
• Knowledge of Singaporean healthcare and insurance regulations.