Officer, Medical Claims

In this position you will....

be managing and handling claims for individual medical and other related products. You will work and build the claims value proposition for the company, and streamline workflow and process design to strive operation excellence.

You will be responsible for…

• Manage the daily operations of the medical claims team and supervise the team performance to provide quality claims service in accordance with the service standards, procedures, guidelines and regulations.
• Ensure all claims are properly handled and review claims processing, decline and settlement procedures when necessary.
• Build service competence in medical claims team by providing suitable coaching, training and development to claims staff.
• Set and monitor reserve adequately and timely and ensure the authority levels laid down are complied with.
• Improve claims service by executing necessary changes to team performance, system and processes.
• Report on Medical claims trend affecting the business result, which may be related to change in market environment and customer dynamics, product coverage or clients with adverse claim experience.
• Assist supervisors in the preparation of management reports and actively drive, run and support projects for the improvement of operation efficiency and service quality.

For you to be successful…

We expect you to be able to demonstrate the following key competencies

Customer Focus

• Demonstrates a customer centric mindset by prioritizing customer needs and addressing concerns with a sense of urgency.
• Aware of the benefits of offering different service solutions to a diversity of customers and helps support adoption.

Curious

• Engages in learning activities and is interested in understanding different ways of doing things including the key activities performed by others in team.
• Understands the value of knowledge sharing and seeks learning in areas beyond own area of focus.
• Keeps up to date on relevant frameworks, applications, software, and/or tools.

Collaborative

• Offers support and contributes to the delivery of shared goals. Displays loyalty and trust to team.
• Co-operates with team members to resolve problems and achieve goals

Communication

• Communicates clearly and actively listens to others.
• Provides others with information they need in a timely manner.
• Receptive to feedback and appropriately expresses own opinions.

Adaptable

• Adapts to changes quickly, flexibly and easily.
• Handles unexpected requirements and ambiguity in a receptive and calm manner.
• Comfortable using different approaches to problem solving.

You will require the following qualifications and skills

• Degree holder in Insurance/Business Administration or related disciplines
• At least 3 years’ experience in General Insurance with hands-on experience on supervision and management in medical claims
• Possessing or in progress of professional insurance qualification such as ACII or ANZIIF is preferred
• Mature, independent, customer-centric, self-motivated, willing to take up new challenges with strong problem-solving skills and leadership skills
• Strong analytical, communication and customer service skills
• Excellent command of written and spoken English and Chinese