Claims Manager Lead

1 month ago


Hong Kong, Central and Western District, Hong Kong SAR China The Cigna Group Full time

About The Role


We are seeking a seasoned Claims Manager to lead our claims team in delivering exceptional customer experiences.


Job Responsibilities



  • Develop and implement strategies to enhance the efficiency of the claims process, including pre-approval of commercial assessments and handling claims processes for both inpatient and outpatient medical claims.
  • Collaborate with customers to communicate pre-approval decisions and resolve any inquiries or concerns in a timely and professional manner.
  • Drive process improvements in claim adjudication and administration, working closely with network service providers when necessary.
  • Manage provider claim enquiries from panel networks and facilitate effective communication to ensure seamless resolution.
  • Prepare regular reports to management, highlighting key performance indicators and areas for improvement.
  • Conduct thorough claim assessments, investigations, and reviews to ensure efficient outcomes and maintain high-quality standards.
  • Maintain individual productivity benchmarks, ensuring timely completion of tasks and projects.
  • Support project initiatives and arrangements as needed.

Requirements



  • Diploma or higher, preferably with insurance-related qualifications such as FLMI or ICA.
  • A minimum of 3 years' experience in claims adjudication and administration, with a strong understanding of pre-approval procedures for medical claims.
  • Excellent teamwork and communication skills, with the ability to work independently and under pressure in a fast-paced environment.
  • Cantonese speaker with excellent English and Chinese language proficiency.
  • A candidate with a medical-related degree but limited claims experience may also be considered.

About Cigna Healthcare


Cigna Healthcare, a division of The Cigna Group, is dedicated to empowering individuals to make informed health choices through our comprehensive healthcare solutions. We strive to deliver personalized support and guidance to our customers, enabling them to achieve optimal health and well-being. With a strong commitment to excellence, we aim to drive growth and improve lives.

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