Bring your career aspirations to life with AIA!

1. Manage a team of Claims assessors to process authorized claims transactions within the required benchmarks
2. Review and approve cases that exceeds subordinates’ authority within required benchmarks

Job Responsibilities:

• Manage a team to process all medical claims requests received as per stipulated requirements

• Manage team to ensure productivity, TAT and Quality SLA are consistently met.

• Review and approve medical claims within own claims approval authority.

• Training of all new joiners on HKCS claims processing rules and products knowledge including Review and Feedback for On-The-Job training cases

• Providing training in System Navigation and Processing Steps, towards certification with Claims Approval Authority, as stipulated in the Claims Approval Authority guidelines.

• Make recommendation for Claims Approval Authority and arrange necessary authorities to be set up in system

• Work with Training Academy to develop training programs for claims assessors.

• Train, coach and develop all team members.

• Prepare all claims reporting including daily SLA, TAT report, monthly Dashboard reporting, Management reports, OT report, BCP/BIA, etc accurately and on time.

• Report and monitor claim experience, quality, trends and patterns analysis, with a view to identifying issues & problems, formulating solutions and strategies as part of the risks management and control responsibilities and its implementation. 

• Involved in process improvement initiatives to improve productivity and quality of claims delivery.

• Organize weekly conference call with Business Partners prepare minutes of meeting and take follow up action items for next meeting.

• Organize and implement team engagement activities to foster closer team spirit and create work life balance environment.

• Conduct regular QC and claims review to ensure claims principles/authorities are adhered to. Review claims decision making process to identify areas of claims risk management concerns for further improvements.

• Performs other responsibilities and duties periodically assigned by immediate manager in order to meet business requirements

Job Requirements:

• Education: Diploma / Bachelor’s Degree in Science Business Management or equivalent

• Experience: At least 5 years in Medical Claims, at least 3 years in supervisory role in Medical Claims department

• Language: Spoken and written in Chinese and English

• Sound knowledge of Life & Employee Benefits and medical products and its administration.

• Good communications and presentation skills

• Self-motivated and customer orientated.

• Sound problem solving.

• Time management skills.

• Computer literate in MS Office.

• Able to commit for long working hour including weekend and public holiday.

Build a career with us as we help our customers and the community live healthier, longer, better lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.