Claims Officer, Outpatient Claims
Location: HONG KONG-HONG KONG-HONG KONG
- Assess and process medical claims according to company’s claims guidelines; Ensure claims are processed within company service standard; Ensure accuracy and review the claims procedures for continuous improvement.
- Liaise with medical service providers for pre-approval arrangement.
- Verify policy liability and alert underwriters on any suspicious, fraudulent claims.
- Reply enquiries from agents, brokers and customers in a timely manner.
- Provide administrative support to group & individual medical clients through handling claims cheque & reject letter, dispatching claims statement / correspondence to the clients; Sorting of daily claims incoming documents and processing registration.
- Contribute to the preparation of statistical reports on claims information required internally or externally.
- Cooperate with other teams to meet the deadlines and expectation of services
- Participate in Claims Ad hoc projects.
- Higher Diploma or above
- At least 3-5 years of working experience in insurance industry, preferable with experience in individual health / employee benefits
- Preferably with insurance professional qualification or near completion of LOMA or ALHC
- Knowledge of the AS400 system
- Good interpersonal skill with service attitude, numeric sensitive and attentive to details.
- Good command of both spoken and written English and Chinese, Mandarin is an advantage & PC skills.
- Associate, Life Management Institute (ALMI)
- Customer Service