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Medical Claims Specialist

1 month ago

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

About the Role

We are seeking a skilled Medical Claims Analyst to join our team at AIA. As a key member of our claims team, you will be responsible for assessing and processing medical claims in accordance with our established procedures and guidelines.

Key Responsibilities:

  • Assess and process claims according to delegated claims authority in accordance with established procedures and guidelines;
  • Support the implementation of claims management strategies and objectives;
  • Reach benchmark of claims processing volume and turnaround time;
  • Assist in handling inquiries or complaints from internal and external customers;
  • Identify and conduct thorough investigation of suspicious cases, including reporting to superior;
  • Perform ad-hoc duties as assigned by supervisor(s).

Requirements:

  • Colleague graduated or above;
  • 5 years' relevant experience in insurance industry, preferably in medical claims;
  • Professional qualification in FLMI, FLHC, etc. will be an advantage;
  • Familiar with operation of medical claims and healthcare network providers;
  • Good communication and interpersonal skills;
  • Detail-minded with strong sense of responsibilities and well-organized;
  • Flexible and customer-oriented;
  • Able to handle multi-task and work under pressure in a fast-paced environment;
  • Good command of both written and spoken English and Chinese;
  • Proficient in MS Office and Chinese Word Processing.