Medical Claims Expert

1 day ago


Hong Kong, Central and Western District, Hong Kong SAR China AIA Full time

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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