Senior Officer, Medical Service

We are seeking a Senior Officer, Medical Service to join our team.

You will assess and settle group health insurance claims arising from policies in force, make recommendations on policies and guidelines, liaise with solicitors and third parties, process claims documents, and answer inquiries.

Responsibilities:

• Handle inquiries from internal and external customers, provide solutions and information within standard turnaround time
• Manage disputes and complaints related to network services
• Maintain and update the network system and its administration
• Collaborate with operation teammates to ensure requests or inquiries are addressed professionally
• Identify and investigate suspicious or fraudulent claims
• Assist in system enhancement and workflow revision
• Backup other teams to reach the company's service standards
• Handle ad-hoc duties as assigned

Requirements:

• Diploma holder or above in any discipline
• Minimum 5 years of relevant experience in medical claims, customer services, or complaint management
• Professional qualification in FLMI, FLHC, etc. is an advantage
• Familiar with medical claims and healthcare network providers
• Good communication and interpersonal skills
• Detail-minded with strong sense of responsibility and organized
• Flexible and customer-oriented
• Able to handle multi-tasks and work under pressure
• Good command of both written and spoken English and Chinese
• Proficient in MS Office and Chinese Word Processing