Medical Claims Operations Manager

1 month ago


Hong Kong, Central and Western District, Hong Kong SAR China Zurich Insurance Company Full time
About the Role

We are seeking a highly skilled Medical Claims Operations Manager to join our team in Hong Kong. As a key member of our operations team, you will be responsible for ensuring the smooth daily operation of our claims section.

Job Description
  • Maintain the efficient processing and settlement of medical claims in accordance with company procedures and regulatory requirements.
  • Monitor and analyze claims operational flow, identifying areas for improvement and implementing changes to enhance quality and efficiency.
  • Collaborate with internal stakeholders to ensure effective communication and resolution of claims-related issues.
  • Develop and implement processes to prevent claims abuse and ensure compliance with company rules and regulations.
Responsibilities
  • Meet service standards and turnaround times for claims processing and settlement.
  • Approve claims cases within designated authority limits, making recommendations to senior management for those exceeding authority limits.
  • Handle customer inquiries and complaints in a professional and timely manner.
  • Provide administrative support in the claims area, including composing correspondence and revising procedures.
  • Analyze and provide advice on complaint/appeal claim cases, developing strategies for resolution.
Requirements
  • Degree/Diploma holder or High School graduate with relevant claims work experience.
  • Professional qualification in Life Insurance (FLMI) is an asset.
  • At least 2 years of experience in Medical Insurance claims handling.
  • Knowledge of Medical insurance products, claims procedure, and operations.
What We Offer

We offer a competitive salary of HK$50,000 - HK$70,000 per month, depending on experience. You will also receive comprehensive benefits, including medical insurance, retirement plan, and paid time off.

Why Choose Us

Zurich Insurance Company is a leading global insurer committed to delivering innovative solutions and exceptional service to our customers. We value diversity and inclusion, and we strive to create a positive work environment that fosters growth and development.



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