Medical Claims Expert
1 day ago
About the Role
As a key member of our team, you will play a pivotal role in ensuring the seamless processing of medical claims in accordance with established procedures and guidelines.
Key Responsibilities:
- Assess and process medical claims in a timely and accurate manner, adhering to delegated claims authority.
- Support the implementation of claims management strategies and objectives, driving business growth and excellence.
- Meet or exceed benchmarked claims processing volumes and turnaround times, demonstrating exceptional productivity and efficiency.
- Provide exceptional customer service, handling inquiries and complaints from internal and external customers with professionalism and poise.
- Identify and conduct thorough investigations of suspicious cases, exercising sound judgment and escalating to superiors as necessary.
- Perform ad-hoc duties as assigned by supervisors, demonstrating flexibility and adaptability in a fast-paced environment.
Requirements:
- A degree or above, preferably in a relevant field.
- A minimum of 5 years' experience in the insurance industry, with a strong background in medical claims.
- Professional qualifications such as FLMI or FLHC are highly valued and can be an advantage.
- Familiarity with medical claims and healthcare network providers, with excellent communication and interpersonal skills.
- Demonstrated attention to detail, with a strong sense of responsibility and organizational skills.
- Ability to work in a fast-paced environment, handling multiple tasks and meeting deadlines with ease.
- Excellent command of both written and spoken English and Chinese, with proficiency in MS Office and Chinese Word Processing.
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