Aetna Senior Technical Claims Specialist in Singapore, Singapore

Req ID: 51699BR

JOB FUNCTION To provide technical management support to the Claims areas ensuring that the technical claims operation is controlled in accordance with policy provisions, company and regulatory requirements, globally teams processes are highly efficient and remain consistent. Provide support and assistance as required to the Global Claims Technical Manager and Head of Global Claims to support delivery of strategic projects as well as day to day delivery of excellent customer service.You will assist in developing a strategic direction for the claims organization. KEY RESPONSIBILITIES· Assists in developing direction and strategy for the claims organization that meets with our corporate strategy in conjunction with the Global Claims Technical Manager and Head of Global Claims.· Ensures consistent and quality claims assessment within all claims operation centers, vendors and TPAs.· Assists with the management of relevant referral mailboxes and work queues in respect to the workload. · Assists the team with technical claims referrals and any complex and high cost claims.· Assists the Technical Claims Manager with internal and external technical audits in line with the Claims audit timetable.· Assists with the management of complex complaints.· Assists in the monitoring and analysis of complaints and QA errors and participates in the discussions for the same with the regional Claims Managers and Technical Claims Managers. · Assists in staff training as and when requested by the Global Claims Technical Manager / Head of Global Claims. · Reviews and analyses Management Information to maximize the efficiency of working practices, procedures and protocols.· Advises/recommends policy wording enhancements.· Maintains up to date market awareness. · Assists in implementing projects as advised by the Global Claims Technical Manager / Head of Global Claims. PRINCIPAL CONTACTS· Internal: All staff and managers· External: Medical personnel, claimants, service providers, brokers and other third parties EDUCATION & EXPERIENCE· Relevant work experience in Claims is required· Knowledge of all areas of claims handling· Excellent written, verbal, and overall people management skills· Experience with claims technology and leading industry practices· PC Literate PERSONAL CHARACTERISTICS· Excellent communication skills – verbal manner and written· Ability to explain concepts simply and unambiguously· Organized and able to prioritize· Ability to deal with high work volumes

Job Function: Claim