# DHS Claims Assessment_Reimbursement, Specialist

**Company**: AIA Vietnam
**Location**: Ho Chi Minh City
**Experience**: senior
**Job type**: full-time
**Category**: Finance
**Industry**: Insurance

**Apply**: https://aia.wd3.myworkdayjobs.com/en-US/External/job/Ho-Chi-Minh-City-VN-AIA-Vietnam/DHS-Claims-Assessment-Reimbursement--Specialist_JR-69267?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_31a441a9-e0b

## Description

At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.

We're looking for a DHS Claims Assessment_Reimbursement, Specialist to report to the Manager, DHS Claims in Ho Chi Minh City.

**THE OPPORTUNITY:**

As a DHS Claims Assessment_Reimbursement, Specialist, you will manage and resolve claims in a fair, efficient, and empathetic manner to ensure policyholders receive the appropriate compensation according to the terms and conditions of their insurance policies.

**ROLES AND RESPONSIBILITIES:**

**1. Re-imbursement claim handling(80%)**

- Manage the entire lifecycle of insurance claims from submission to resolution.

- Evaluate claims based on policy coverage, medical necessity, and contractual agreements.

- Ensure claims processing adheres to regulatory requirements and claims procedure.

- Provide guidelines and advice to team members or make final decisions for borderline cases.

- Process payments and ensure policy benefits and values are calculated correctly.

- Communicate with customers and providers to request additional documents.

- Work with POS teams, actuaries, and underwriters for policy value calculations.

- Prepare claims letters to customers and keep agents updated about claims status and results.

- Conduct quality assurance and monitoring of claim handling processes.

- Address inquiries and issues related to claims from healthcare providers, policyholders, and internal stakeholders.

- Ensure smooth operations between healthcare teams and providers.

**2. Direct Billing claim handling(20%)**

- Support or handle cashless claims in case of high volumes.

- Back up assessors responsible for direct billing hotlines.

**JOB REQUIREMENTS:**

- University graduate.

- At least 3 years of experience in medical claims at an insurance company.

- LOMA certificate.

- Good communication and interpersonal skills, decision-making skills, management skills, and planning skills.

- Medical background is preferred.

- Customer service mindset.

- Good English speaking and writing skills.

## Skills

### Required
- insurance claims handling
- policy evaluation
- regulatory compliance
- communication
- interpersonal skills
- decision-making
- management
- planning

### Nice to have
- medical background
- LOMA certificate

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Source: [Apply at aia.wd3.myworkdayjobs.com](https://aia.wd3.myworkdayjobs.com/en-US/External/job/Ho-Chi-Minh-City-VN-AIA-Vietnam/DHS-Claims-Assessment-Reimbursement--Specialist_JR-69267?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)