Assistant Vice President - Medical Claims
You will be responsible to handle and manage complex claims and claim investigation under the health plans . You will also be responsible to mentor and guide junior staff to build team competency and ensure KPIs are met. You will be given opportunity to be part of an exciting team with involvement in customer service initiatives and projects to improve the claims experience and process efficiency. The Job
- Provide accurate and timely assessment of medical claims within the required service standards and ensure that claims are paid accurately and promptly
- Handle claim investigation
- Mentor and guide junior staff to build claim assessment competency, medical knowledge and communication skills through coaching and training.
- Build collaborative relationships with and ensure that claims are well managed for both internal and external key stakeholders (i.e policyholders, beneficiaries, distribution servicing representatives, medical institutions) to achieve claims business objectives
- Review claims processes and participate in process improvement projects, initiatives and system enhancement for the department, including establish claims best practices
- Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
- Maintains awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company.
- Highlights any potential concerns /risks and proactively shares best risk management practices.
- Any othe ad-hoc projects assigned by supervisor
- Degree or Professional Insurance Certificate with at least 8 years of relevant accident and health claims experience.
- Mid-level claims assessors who are looking for greater challenges and greater exposures
- Strong knowledge on integrated shield claim processes and industry initiatives in managing medical claim cost
- Strong knowledge on inpatient claims and integrated shield claim processes and industry initiatives in managing medical claim cost
- Strong leadership and people management skills
- Strong analytical, business writing and communication skills
- Good medical knowledge and ability to explain medical conditions in insurance context
- Good business acumen with long term vision
- Customer-centric and meticulous with the ability to work under pressure
- Excellent interpersonal skills to effectively communicate with all stakeholders
- A team player
About Great Eastern Established in 1908, Great Eastern places customers at the heart of everything we do. Our legacy extends beyond our products and services to our culture, which is defined by our core values and how we work. As champions of Integrity, Initiative and Involvement, our core values act as a compass, guiding and inspiring us to embrace the behaviours associated with each value, upholding our promise to our customers - to continue doing our best for them in a sustainable manner. We work collaboratively with our stakeholders to look for candidates who exhibit or have the potential to embrace our core values and associated behaviours, as these are the key traits that we expect from our employees as they develop their careers with us. We embrace inclusivity, giving all employees an equal opportunity to shine and play their role in exploring possibilities to deliver innovative insurance solutions. Since 2018, Great Eastern has been a signatory to the United Nations (UN) Principles of Sustainable Insurance. Our sustainability approach around environmental, social, and governance (ESG) considerations play a key role in every business decision we make. We are committed to being a sustainability-driven company to achieve a low-carbon economy by managing the environmental footprint of our operations and incorporating ESG considerations in our investment portfolios; improving people's lives by actively helping customers live healthier, better and longer; and drive responsible business practices through material ESG risk management. To all recruitment agencies:
- High level of integrity, takes accountability of work and good attitude over teamwork.
- Takes initiative to improve current state of things and adaptable to embrace new changes.
Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.
Please note that our career opportunities are only posted on our Career Website (http://grp.gelife.co/findacareer) and on our authorised job platforms which are specifically LinkedIn, JobStreet and eFinancialCareers. We do not initiate any unsolicited calls and all official emails from Great Eastern will be sent from email addresses ending with “@greateasternlife.com”. Should you receive any communications outside from these channels listed, please do not provide any personal information and do reach out to us at GreatCareers@GreatEasternLife.com or at 6248 2990 for us to assist you and confirm the legitimacy of the content.