Medical Claims Specialist

About The Company At Foundation Healthcare, we believe that all stakeholders in the healthcare ecosystem must work closely together to deliver better value for the patients we care for. We believe healthcare should be: accessible, affordable and accountable. Currently one of the largest multi-specialty private specialist groups in Singapore, we are supported by our proprietary technology platform and strategic partnerships. Work with us to reimagine and build out the "foundation" for modern healthcare. Our Culture We dream big. We push boundaries. All while remembering the importance of laying the right foundations to build a sustainable organization. We are a team of passionate and dynamic individuals pursuing our best daily. We respect everyone's ideas and talents, and we embrace diversity. About The Role The Medical Claims Specialist role allows the job holder to experience medical claims management at both tactical and strategic levels. The position reports directly to the Chief Commercial Officer and will be responsible for the following: Value Based Care Strategy – participate in the development of progressive strategies to: • Eliminate waste in the healthcare delivery process • Improve patient, provider and payor experience • Execute tactical initiatives between healthcare providers and payors • Performance (cost and quality) monitoring • Develop a culture that is consistent with the ethos of FHH and support FHH’s • Drive to make healthcare more accessible, affordable and accountable Medical Claims Lifecycle Management – to improve the claims management processes, including: • Harmonising, digitising and automating processes across all our clinics • Improve our care teams’ knowledge in insurance products to better assist our patients • Performance management (maintain monthly statistical reports to facilitate benchmarking and performance management for management decision making) • Manage and maintain system data relating to fee schedules, accounts, pricing and all pre-agreed working arrangements • Instil collaboration between parties (providers, patients, payors) • Provide feedback to our network of providers and payors or TPAs regarding their performance under the terms of their contract, identify and address quality of care and service issues Foundation Healthcare is an equal opportunity employer. We thrive on diversity and are committed to creating an inclusive environment for all employees.