To ensure accurate and timely assessment of pre-claims authorization requests. The role is focused on giving customers assurance before their admissions by delivering precise evaluations, clear communication and assurance of coverage. This includes managing pre-claim investigations, liaising with medical professionals, and resolving escalated cases promptly to meet or exceed service standards.

• Provide accurate and timely assessment of pre-claims authorization requests within service standards.

• Manage and review specialized pre-claim investigations and appeals with fairness and precision.

• Liaise with medical professionals, hospitals and policyholders to clarify requirements for pre-claim authorization approvals.

• Deliver excellent service by providing assurance to customers and exceeding expectations in pre-claims authorization.  

• Proactively identify and recommend alternative solutions to give customers confidence before admissons. 

• Oversee escalated cases to ensure prompt resolution in line with service quality commitments.

• Take accountability for business and regulatory compliance, mitigating risks effectively.

• Stay updated on regulatory changes and industry development to anticipate and manage emerging risks.

• Undertake any other ad-hoc projects as assigned.

• Bachelor's degree in business, healthcare administration, or related discipline.

• 5–8 years of experience in customer service operations, preferably in insurance claims.

• Strong problem-solving, communication, and stakeholder management skills.

• Familiar with letter of guarantee issuance workflows and healthcare provider interactions.

How you succeed

·       Champion and embody our Core Values in everyday tasks and interactions.

·       Demonstrate high level of integrity and accountability.

·       Take initiative to drive improvements and embrace change.

·       Take accountability of business and regulatory compliance risks, implementing measures to mitigate them effectively.

·       Keep abreast with industry trends, regulatory compliance, and emerging threats and technologies to understand and highlight potential concerns/ risks to safeguard our company proactively.