- Management Reporting
- Product Development
Assistant Manager, Group Claims
Location: Hong Kong-Kowloon-Kowloon
The incumbent will lead the team to manage the day-to-day group inpatient/outpatient claims operations and deliver the best quality claims service to our policyholders, members, brokers and business partners.
- Adjudicate claims under different distribution channels independently and ensure the effectiveness of the claim administration processes;
- Supervise subordinates to deliver the required claims service to both our internal and external customers;
Handle claim enquiries and resolve complaints from external Brokerage and internal clients;
Conduct process control / audit internally and the Network / Third Party Administrators (TPA) to ensure adherence to standards and guidelines set by Cigna and regulations;
- Prepare monthly management report and ad-hoc report for claims management;
- Analyze claims data to identify problem’s root causes, propose resolutions and execute improvement plans;
- Work closely with internal IT and external IT vendors to report and test system issues. Identify opportunities for system enhancements and perform full cycle UAT to ensure successful production;
Support product development and sales function by conducting claims training for both internal and external parties.
Handle ad hoc projects and duties.
- Diploma or above, preferably with insurance-related qualifications, e.g. FLMI, ICA;
- At least 5 years’ experience in claims adjudication / administration of which at least 2 years in supervisory role;
- Experience in working or managing the Network / Third Party Administrators (TPA) is highly preferable;
- Proven track record of working with IT, vendors and stakeholders on developing user requirements and test cases for system, and conducting UAT;
- Good team player, able to work independently and under pressure;
- Possess customer centricity mindset;
- Good command of both English and Chinese.
|Career Level||Intermediate (3-6 years)|
|Education Level||Higher Diploma / Associate Degree|
|Qualification||Fellow, Life Management Institute (FLMI)|