Manager, Medical Claims (Insurance Industry, Shield Claims, Hybrid, $6K) (Id: 706283)

Responsibilities: Assess integrated shield claims and manage appeals to guarantee prompt and correct payments. Engage with medical institutions, policyholders, and internal teams to gather clinical information and clarify outstanding requirements. Deliver comprehensive and timely evaluations of medical claims, ensuring fair payouts in alignment with service standards and policy terms. Adhere to internal policies and regulatory requirements, maintaining the integrity of claims operations while managing compliance risks. Identify claim patterns and recommend improvements to strengthen claims controls and streamline processes. Communicate clearly and empathetically with policyholders, medical professionals, and stakeholders to facilitate a smooth claims process. Participate in reviews and initiatives aimed at enhancing efficiency and customer experience. Requirements: Bachelor’s degree or Professional Insurance Certificate in a relevant field such as insurance or healthcare. Minimum of 5 years of experience in claims processing. Strong understanding of medical practices, terminology, and insurance policy terms. Excellent analytical skills with the ability to interpret complex medical data and make sound decisions under pressure. Detail-oriented with a proven ability to manage high processing volumes without compromising quality. Customer-focused with strong relationship-building skills and effective, empathetic communication. Team-oriented with a willingness to learn and thrive in a dynamic, collaborative environment that prioritizes innovation and service excellence. Interested candidates who wish to apply for the advertised position, please click on “Apply ”. We regret that only shortlisted candidates will be notified. EA License No.: 01C4394 (Persol Singapore PTE LTD) By sending us your personal data and curriculum vitae (CV), you are deemed to consent to Persol Singapore Pte Ltd and its affiliates to collect, use and disclose your personal data for the purposes set out in the Privacy Policy available at https://www.persolsingapore.com/policies. You acknowledge that you have read, understood, and agree with the Privacy Policy