Medical Claims Specialist
3 weeks ago
About the Role
We are seeking a skilled Medical Claims Analyst to join our team at AIA. As a Medical Claims Analyst, you will be responsible for assessing and processing claims based on delegated claims authority in accordance with established procedures and guidelines.
Duties and Responsibilities:
- Assess and process claims based on delegated claims authority in accordance with established procedures and guidelines;
- Support the implementation of claims management strategies and objectives;
- Meet benchmarked claims processing volume and turnaround time;
- Assist in handling inquiries or complaints from internal and external customers;
- Identify and conduct thorough investigations of suspicious cases, including reporting to superiors;
- Perform ad-hoc duties as assigned by supervisors.
Requirements:
- Colleague with a degree or above and at least 2 years' relevant experience in medical claims;
- Professional qualifications in FLMI, FLHC, etc. are advantageous;
- Familiarity with medical claims operations and healthcare network providers;
- Excellent communication and interpersonal skills;
- Detail-oriented with a strong sense of responsibility and organization;
- Flexible and customer-focused;
- Able to handle multiple tasks and work under pressure in a fast-paced environment;
- Proficient in MS Office and Chinese Word Processing;
- Good command of both written and spoken English and Chinese.
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