Senior Customer Assistant - Health Insurance (2419-SCAHI)

Our client in the financial sector is currently seeking to recruit a Senior Customer Assistant - Health Insurance who will handle claims intimation to settlement. The successful candidate will also participate towards achievement of set targets.

Responsibilities:

• Attend to clients and intermediaries and to provide technical advice regarding Medical claims.
• Ensure that all set targets are met within defined timeframes.
• Assist in the compilation of data and statistical reports.
• To handle claims efficiently from notification to settlement and effect payments as per terms and conditions.
• Compile and process claims received within KPI.
• Gather all supporting documents and other relevant information for claims settlement.
• Verify claims against coverage given and other terms and conditions.
• Follow up with internal Department in case of queries.
• Follow up on non-valid claims.
• Gather information for Incomplete & Non-Valid claims and request for missing information.
• Check outstanding premiums prior to settlement of claims.
• Provide assistance to Customers/Brokers/Agents on 'Terms & Conditions', medical protocol and remaining balances.
• Assist walk in clients for their claims submission for complex cases.
• Interact with the Accounts Department for rejected funds for payment made by Direct Credit.
• Prepare letters (Chronic/Non-Valid/Repetitive/Incomplete/Long Term/Notice).
• Provide assistance to the medical insurance team when required.

Profile:

• Either School Certificate or GCE O Level with credit in at least 5 subjects including English Language, French and Mathematics plus HSC/GCE A Level in at least three subjects (3 Main) or equivalent (IB, Baccalaureate). OR
• Part Professional qualifications progressing towards completion (at least Diploma level) of ACII. OR
• At least a Diploma in a related field of competence.
• 3-year relevant working experience.
• Good understanding of common health insurance industry practices, concepts and procedures.
• Proficient in Microsoft Office applications (Excel & Word).
• Good rapport building and interpersonal skills with strong negotiating and influencing skills.