Claims Specialist / Senior Claims Specialist, WICA

Job Description

The commercial claim specialist plays a pivotal role in managing and assessing workman injury claims. This position requires a seasoned professional with extensive expertise in the general insurance domain, particularly in the field of claim assessment.

Key Responsibilities

• Claims assessment: Utilize deep knowledge and experience in the general insurance space to meticulously assess, investigate, and evaluate workman injury compensation claims.
• Policy adherence: Ensure compliance with company policies, local regulations, and industry standards while handling and processing workman injury claim.
• Regulatory adherence: Apply strong understanding and experience in assessing claims in strict compliance with regulatory requirements, ensuring alignment with applicable laws and industry standards.
• Communication and coordination: Collaborate effectively with internal teams such as operation, finance and sales; external stakeholders which include distributors, loss adjustors, investigators, lawyers, medical experts; and claimants to facilitate seamless claim processing and resolution.
• Documentation and reporting: Maintain accurate records, prepare comprehensive reports, and document all stages of the claims process, ensuring clarity, transparency, and compliance.
• Negotiation and settlement: Negotiate effectively with stakeholders to reach fair and equitable settlements for workman injury claims, considering all relevant factors and legal precedents.
• Continuous improvement: Enhance claim handling procedures and contribute to the continuous improvement of claims management protocols by staying updated with industry trends, legal changes, and best practices.
• Market knowledge: Stay updated with market trends, regulatory trends and in particular, MOM WICA legislative changes. 
• Customer experience: Deliver excellent service to claimants and distributors and ensure that customers have a positive claims experience.

Qualifications and skills

• A minimum of 2 to 3 years of experience in assessing and managing workman injury compensation claims.
• Recognized diploma in any discipline.
• Possess CGI certificate.
• Profound understanding of workman injury compensation processes, Singapore regulations and relevant legal frameworks. Knowledge in medical claims will be preferred.
• Excellent verbal and written communication skills to interact with diverse stakeholders and convey complex information clearly and concisely.
• Meticulous attention to detail to ensure accuracy in claim assessment, documentation and reporting.
• Ability to adapt to changing environment, prioritize tasks efficiently, and handle a variety of tasks effectively.
• Demonstrated ability to perform effectively in high-pressure environments, managing competing priorities while maintaining accuracy and quality in claims assessment.
• Good knowledge of MS Office software and any other technology applications.