Offshore Claims ConsultantPrimary Location: Singapore, SGP
Additional Locations: SGP-Singapore Apply
This role is critical to our SEA business, ensuring the consistent and timely support of all their member's support needs, but especially focused on claims performance. In addition, this role will need to work closely with the SEA markets to understand and align on any specific requirements. The SEA service model must be simple, measurable, and deliver high-quality member experiences within our agreed SLAs, with a year on year objective to maintain and improve quality standards, whilst driving efficiency.
- End‐to‐end ownership of claims processing for Philippines and Vietnam books of business, including overall inventory management, achieving TATs, management of suspending & pend volumes, quality control, and customer outreach.
- Single Point of Contact for HGS teams (MST Manila & Claims India), PH & VT SAM, Regional & Global claims team interlock. Personally responsible for the error handling, query resolution, rework, complex, and high cost claims processing.
- For these markets, a majority of claims are being submitted by email via the broker. These claims are scanned by MST Manila to create and upload to a DME. Claims investigation is required for illegible and missing claims. This role will work across MST Manilla and HGS India Claims and coordinating with local, in‐market teams to resolve the issues.
- Report management:
- Monthly audits of completed QA results (processed by HGS & VN onshore) with follow up actions identified and carried through in a timely manner
- In‐Region Provider claims audit/reconciliations
- Provides informal guidance to colleagues
- Contributes to the achievement of team objectives
- Contributes to the resolution of moderately complex problems.
Background Experience Desired
- 5+ years claims management experience
- Demonstrated critical thinking skills
- Excellent written and verbal communication skills
- Good collaborative skill and able to work with offshore teams to drive results
- Proven track record of building and sustain business relationships across complex/matrix organizations.
- Capable of identifying performance improvement opportunities
- Demonstrated ability to solve problems independently, with a strong track record of successful customer service/stakeholder management experience
- Experience with claims technology and leading industry practices a plus.
- Excellent written and verbal communication
- Strong Excel skills a must
71614EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer
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