Bring your career aspirations to life with AIA!
Responsible for determining the validity and authorising settlement of individual health insurance claimsJob Descriptions:
- Prior Authorization Approval (50%):
- Carry out detailed assessments in line with established standards, procedures and guidance provided
- Approve Prior Authorization requests within designated authority level and makes recommendation to senior within the benchmarked TAT
- Negotiate with the service providers to follow the logic of agreed fee
- Issues Letter of Guarantee whenever required
- Provide case management and approve Prior Authorization requests under the technical direction of Medical Officer
- Enquiry / Hotline support (20%):
- Handle enquiries from Claims Team and promote improvement to reduce back and forth communication
- Handle enquiries from Call Centre on PA status
- Review non-office hotlines call log and follow up PA process
- Coordinate with Individual Life Claims Team on panel claims settlement (15%):
- Review panel EDI files and communicates with panel administrators for incorrect billings
- Coordinate with Claims team and ensure panel claim cases are settled within agreed TAT
- Other duties and responsibilities (15%):
- Other duties and responsibilities as assigned by supervisor
- Work weekends as and when there is a business need
- Administrative duties such as updating rosters, handling faxes, handling LOGs etc.
Job Requirements:
Degree: Bachelor’s Degree in Science related field such as Biology, Biotechnology, Biomedical Science, Medicine, Food Science, Nutrition, Business Management or equivalent.
Language: Spoken and written in Chinese and English, with strong written 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.
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