Executive, Life Claims

Key Responsibilities

• Perform administrative duties such as claim registration, preparation of correspondences, and payments.
• Assess policy liability, compute, and determine the claim amount payable based on policy cover and management guidelines for individual personal life insurance and managed healthcare systems.
• Recommend the payment or rejection of claims and approve those within the authority limit, ensuring timely and fair settlement of claims.
• Ensure that claims are settled within the target time set and that pending claims are reviewed within the target period.
• Ensure that claims are processed in accordance with the service level agreements set within the organization and with external bodies such as the CPF Board and vendors for panel clinics.
• Work closely and maintain good rapport with representatives (financial consultants, advisers, brokers, etc.), officers, and staff of other departments.
• Communicate effectively with claimants and related parties, reinsurers, and external stakeholders such as the CPF Board, and hospitals, clinics, nursing homes, and vendors for panel clinics during claims administration.
• Handle claim enquiries, service recovery, complaints, appeals, and customer care matters.
• Review and suggest process improvements for developing or implementing best practices.
• Participate in operation efficiency and AI-driven projects to enhance claims processes.
• Undertake any projects or duties as assigned by the Section Lead or Head of Function.

As an Executive in the Life and Health Operations (LHO) department, you will report to the Life Claims Section Lead and manage life claim assessment, including the managed healthcare system.

Qualifications

• Diploma holder with 1-2 years of experience in basic life claims.
• Good policy language skills enabling accurate and consistent policy wording interpretation.
• Good critical thinking skills and the ability to handle computations.
• Good written and communication skills; a committed team player.
• Meticulous with strong analytical and organizational skills.
• Ability to multitask and work independently.
• Ability to work under pressure and manage deadlines.
• Customer-centric mindset.