Medical Case Assessor

About the team

Doctor Anywhere's Operations team is a crucial part of the company. We ensure the day-to-day excellence of our TPA business, virtual and in-person clinical services, resolving operational issues in a timely manner and providing the best customer experience possible. We make sure that our customers remain our top priority.

About the role

We are seeking a Medical Case Assessor who will assess Pre-authorization case assignments to recommend approval or decline of pre-authorization requests according to Policy’s terms & benefits and are settled within the agreed turnaround time.

The ideal candidate will have a mindset of continuous improvement and change and will demonstrate curiosity, collaboration and the ability to deal with ambiguity especially in a start-up environment.

This role is based in Singapore and reports directly to the Senior Manager, Health Connect Team.

A summary of the key responsibilities and requirements are as follows:

• Assess Pre-authorization cases assignments and recommend your decision to approve or decline pre-authorization requests within the agreed turnaround time in an efficient and timely manner.

• Ensure any suggested treatment plans fall within policy terms and conditions and guidelines.

• Conduct further investigating questionable scenarios to determine policy liability and negotiate on fees charges in accordance with guidelines and benchmarks.

• Work closely with Specialists, Clinics, Hospitals and other internal and external stakeholder(s) in relation to the pre-authorization requests.

• Communicate and follow-up with Life Assured in relation to the Pre-Authorization or enquiries whenever necessary.

• Maintain accurate case records and all related communication.

• Ensure that pending cases are followed up and managed on a timely basis.

• Ensure compliance with internal and external regulatory guidelines e.g. MOH TOSP and benchmarks.

• Be exposed to data analytics tools as part of your assessment work.

• Ensure strict adherence to company Standard Operating Procedures.

• Any other special projects and ad-hoc duties assigned when appropriate.

About you

• Open to entry level Diploma/Degree without experience, preferably within studies of Bio sciences, Nursing or Statistics.

• Experience in Healthcare/Insurance/Third-Party Administrators industries will be advantageous.

• Ability to communicate clearly in both writing and verbally.

• Ability to handle and mediate sensitive issues calmly, empathetically and professionally.

• Proficient in Microsoft Office applications.

• Unquestioned integrity and high standards in the work you do.

• A start-up attitude - you take full ownership of things that you do, willing to go out of your comfort zones and take on new challenges.

• Comfortable with ambiguity and flexible to learn new things - we’re not done growing, and heading into uncharted territories is part of the fun!

About Doctor Anywhere

Doctor Anywhere (DA) is a regional tech-enabled, omnichannel healthcare provider delivering care to 2.5 million users across 6 countries in Southeast Asia. Founded in 2017 with a mission to make healthcare simple, accessible, and efficient for all, DA leverages technology to enable individuals towards preventive, long-term health via holistic offerings including our telehealth app, physical clinics and pharmacies, mental wellness, specialist consults, and also an online health & wellness marketplace for supplements, healthy snacks, home-based health screening and vaccinations.

DA’s goal is to build a regional digital healthcare ecosystem, advanced by the 3,000 GPs and specialists within our regional network, over 1,000 corporate organizations, and 25 regional insurers we work with. Grounded in our motto “Keep Going, Keep Growing”, our team strives towards excellence, with innovation and collaboration at our core, and values diversity in perspectives brought by every member. Join us in our mission to transform Southeast Asia’s healthcare future!

Not for you? We have other opportunities that may interest you or someone you know. Feel free to visit us at our careers page - https://doctoranywhere.com/job-listing/ for more information.