Manager, Provider Management & Claims Projects

Full-time
Intermediate (3-6 years)

Posted 

Technical Skills

  • Audit
  • Claims
  • Customer Service
  • Management Reporting
  • Microsoft Excel
  • Product Development
  • Training

Job Description

Manager, Provider Management & Claims Projects

Location: Hong Kong-Kowloon-Kowloon

The incumbent will lead up the various claims projects and system enhancement initiatives.  He/She also oversees the daily operations of network and other claims service providers.
Job Responsibilities:
  • Initiate & lead operation efficiency projects and drive system enhancements to uplift operation efficiency and customer experience and to meet business priorities.  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;
  • Participate in customer proposition projects by providing professional advice in claims.
  • Ensure the effectiveness of the claim adjudication and administration processes of network service providers / Third Party Administrators (TPA) to achieve various KPIs;
  • Ensure  network service providers / Third Party Administrators (TPA) delivering  quality services to both our internal and external customers;
  • Conduct audit review of claims processing for TPA / vendors to identify improvement areas and ensure adherence to standards and guidelines set up the company and regulators;
  • Review the service agreement regularly to update the scope of services, terms and pricing;
  • Liaise with external vendors to support new or enhanced services to meet business priorities.
  • Handle claim enquiries from external and internal customers;
  • Prepare monthly management report and ad-hoc report for claims management;
  • Analyze claims data to identify improvement opportunities,  propose resolutions and execute improvement plans;
  • Conduct claims training/briefing for both internal & external parties

Qualifications

  • 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 with or managing the Network service providers / Third Party Administrators (TPA) ;
  • Proven track record of working with IT, vendors and stakeholders on product development and claims projects which involve developing user requirements and test cases and conducting UAT;
  • Proficiency in Microsoft Excel with analytical mindset;
  • Good team player, able to work independently and under pressure in a fast-paced environment;
  • Possess customer centricity mindset;
  • Excellent interpersonal, communication and influencing skills;
  • Cantonese speaker with good command of both English and Chinese
Employment TypeFull-time
Career LevelIntermediate (3-6 years)
Education LevelHigher Diploma / Associate Degree
QualificationFellow, Life Management Institute (FLMI)
LanguageEnglish, Cantonese
Cigna Worldwide Life Insurance CoInsurance and Reinsurance

28 Hennessy Road, Wan Chai, Hong Kong

directions_walk7 mins walk from Wan Chai Station