Analyst, Group Claims

Singlife is a leading homegrown financial services company, offering consumers a better way to financial freedom. Through innovative, technology-enabled solutions and a wide range of products and services, Singlife provides consumers control over their financial wellbeing at every stage of their lives.

In addition to a comprehensive suite of insurance plans, employee benefits, partnerships with financial adviser channels and bancassurance, Singlife offers investment and advisory solutions through its GROW with Singlife platform. It also offers the Singlife Account, a mobile-first insurance savings plan.

Singlife is the exclusive insurance provider for the Ministry of Defence, Ministry of Home Affairs and Public Officers Group Insurance Scheme. Singlife is also an official signatory of the United Nations Principles for Sustainable Insurance and the United Nations-supported Principles for Responsible Investment, affirming its commitment to finding a better way to sustainability.

The merger of Aviva Singapore and Singlife was announced in September 2020 and created one of the largest homegrown financial services companies in Singapore in a deal valued at S$3.2 billion. It was the largest insurance deal in Singapore at the time. Singlife was subsequently acquired by Sumitomo Life in March 2024, one of Japan’s leading life insurers, which valued Singlife at S$4.6 billion, making the transaction one of the largest insurance deals in Southeast Asia.

Purpose of the Role

1. Review and assess local and overseas medical and non-medical claims within policy terms and conditions and claims authority limit within stipulated turnaround time.
2. Review and approve Pre-Authorisation/LOG requests within policy terms and conditions and MOH benchmark.
3. Coordinate with medical providers, policyholders, and other stakeholders for additional information when necessary.
4. Handle follow-ups on claims with unsuccessful bank transfers and CPF failures, such as voiding claims, creating refund entry and reprocessing of claims.
5. Request and follow-up on the creation of insured members and medical service providers for affected claims.
6. Prepare claim settlement letters and scan claims documents to shared drive.
7. Update Statements of Accounts relating to hospital bills/claim settlements.
8. Communicate with policyholders, healthcare providers, intermediaries and internal teams to resolve issues and clarify claim details.
9. Address claim disputes or queries from clients or intermediaries in a professional and efficient manner.
10. Follow up with clinics/hospitals for enquiries on billing details.
11. Follow up on monthly outstanding receivables, including but not limited to requesting refund for overpayments from relevant parties such as claimants, hospitals, insurers and CPF Board.
12. Prepare meeting minutes and reports, including but not limited to daily claims report, statistical analysis and trends.
13. Handle finance and payment activities including but not limited to voiding claims, creating refund entries, raising and approving receipt voucher cancellations and cheque cancellations.
14. Participate in projects and enhancement in claims system improvement including but not limited to data collection, UAT testing and suggest improvements to the claims assessment process to increase efficiency and accuracy.
15. Identify potential fraud or inconsistencies and report them to management.
16. Other assigned tasks.

Key Responsibilities

1. Assess claims using Group Insurance core systems, other business systems including vendors’ systems.
2. Communicate claims decision clearly.
3. Respond to queries in a timely manner.
4. Manage his/her workload to achieve required service levels.
5. Arrive at customer-oriented outcomes by working with key stakeholders.
6. Participate in activities that improve processes, productivity, and services and solutions to customers.
7. Engage key stakeholders when handling appeal cases or complex cases.
8. Establish good working relationships with intermediaries and clients.

Requirements

1. Minimally 2 years of experience in assessing group claims.
2. Familiar with group insurance products like Group Term Life, Group Personal Accident, Group Disability Income, Group Critical Illness, Group Hospitalization & Surgical and Group Outpatient.
3. Good Oral & Written Communication.
4. Completion of Health Insurance Certificate, M5 & M9 is preferred.
5. Diploma or Degree.
6. Good Microsoft Office Skills (e.g. Word, Excel, PowerPoint).