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About this position

This position is assigned to provide investigation support services to Claim department, Pre-authorization team and Underwriting team. This position will plan the investigation cases and resources to ensure that the investigation cases are performed in timely manner. And provides administration support for policy voidance.

Responsibilities

• Claims Investigation
• Select the location for investigation to investigate administration team for checking and request medical history from selected hospitals.
• Review medical histories and report back to owners (Claim team, Pre-authorization team, Underwriting team) for further assessment.
• Admin Support
• Support for claim consulting from Claim team, Sale team, CS team etc.
• Support for medical training to claim team.
• Support fax claim service process.
• Policy Voidance
• Review and summary medical history.
• Propose case to claim management for policy voidance.
• Prepare void letter.
• Inform membership team to refund premium.
• Explain void reason to customer and related parties (If any).
• Support other teams in Claims department when needed such as reimbursement, provider, fax claims assessment, etc.

Requirements

• Bachelor’s or Master’s Degree in Business Administration, Nursing, Business of Sciences (Medical Technology), or other related field.
• 1 - 2 years experience in Claims Assessor or other related fields in insurance industry.

Benefits