Claims Officer, Outpatient Claims

Intermediate (3-6 years)

Technical Skills

  • Claims
  • Customer Service

Job Description

Claims Officer, Outpatient Claims


  • 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.

Employment TypeFull-time
Career LevelIntermediate (3-6 years)
Education LevelHigher Diploma / Associate Degree
QualificationAssociate, Life Management Institute (ALMI)
LanguageEnglish, Cantonese, Mandarin (Putonghua)
AXAInsurance and Reinsurance

42/F., AXA Tower, Landmark East, 100 How Ming Street, Kwun Tong

directions_walk8 mins walk from Kwun Tong Station