Contract Executive, Service Support (Income Shield Op Claim)

Overview

The Life and Health Operations (LHO) division plays a crucial role in delivering affordable, comprehensive life and health insurance products while maintaining efficient processes to ensure excellent customer service.

Key Responsibilities

• Handle assessment and processing of all IncomeShield claims, emphasizing outpatient claims.
• Evaluate policy liabilities, conduct investigations, and determine payable amounts in adherence to Income's policy terms and management guidelines.
• Collect, analyze, and submit claims reports as required.
• Prepare reports on claims requiring management escalation and present these cases at committee meetings.
• Address enquiries and resolve complaints from claimants.
• Coordinate with intermediaries, hospitals, and other external stakeholders.
• Perform additional duties or projects as assigned by the supervisor or head of section.

Qualifications and Experience

• Possess at least a Diploma or Degree in any discipline.
• Hold Health Insurance (HI) certification.
• Minimum of 2 years individual claims experience; prior exposure to Shield claim processing and assessment is preferred.
• Skilled in managing insurance claim enquiries and negotiations professionally.
• Strong analytical abilities, detail-oriented with competency in handling complex calculations.
• Self-driven team player mindset.