Health Claims Admin Assistant

2 days ago

กรงเทพมหานคร, Thailand FWD Insurance Full time

About FWD Group

FWD Group is a pan-Asian life and health insurance business that serves approximately 30 million customers across 10 markets, including BRI Life in Indonesia. FWD’s customer-led and digitally enabled approach aims to deliver innovative propositions, easy-to-understand products and a simpler insurance experience. Established in 2013, the company operates in some of the fastest-growing insurance markets in the world with a vision of changing the way people feel about insurance.

For more information, please visit

Job Purpose

The Hospital Claim Associate is required to manage claims administrative functions including registration, data entry, hospital bill and payment includes all letters at claim relate to output deliverable and take care of the hospital claim team to work successfully within SLA. The job holder is accountable for ensuring sound and responsive day-to-day operations in order to confident customers, distributed and brokers in FWD operations that directly effect to the continuance of health insurance.

Key Responsibilities

Achievement of claim payment administration within SLA
- Establishes and reviews for update the resource planning for handling 7 days service of cashless claim (8.30am-8pm) including inquiry, follow up pending, complaint handling to increase quality of service.
- To manage claims administrative functions including registration, data entry, network bill clearing and payment via TMB Biz direct, claim notification and correspondence, accuracy and timely of claim processing.
- Oversee daily operations and coordinate the activities of the claim team to ensure efficient workflow and timely processing of claims.
- Support hospital in eligibility checking of customer insurance coverage within SLA.
- Act as the primary point of contact for resolving complex claims issues and escalations, ensuring that all problems are addressed promptly and effectively
- Other job assignment

Effective Claim Administration Service
- Handle claim process and consistently deliver with high quality standards, accurate information, and within service level agreement
- Organize and conduct training sessions for new team members as well as ongoing training for current staff to ensure everyone is up-to-date with policies and procedures.
- Monitors the preparation of claim reports includes aging report to ensure the accurate and reliable information within the dateline of each report by regulators and other parties, identifying trends and area for improvement and presenting these findings to senior management.
- Manages the pipeline of claim to ensure all pending cases and suspense could be complete within SLA
- Monitors pending duration and follow up with distributors, hospitals or investigators on a pending claim transaction

Developing a differentiated experience
- Develops action plan to create a differentiated experience that positively respond to customers’ expectation.

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