# Medical Claims Manager

**Company**: Sun Life
**Location**: Hunghom, Kowloon
**Experience**: senior
**Job type**: full-time
**Category**: Healthcare
**Industry**: Insurance

**Apply**: https://sunlife.wd3.myworkdayjobs.com/en-US/Experienced-Jobs/job/Hunghom-Kowloon-Hong-Kong/Manager-I--Claims-Services_JR00128219-2?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_56743475-84b

## Description

You will be joining Sun Life, a leading financial services company, as a Medical Claims Manager in Hunghom, Kowloon, Hong Kong. This is a full-time role that involves managing pre-approval medical services, overseeing junior case reviews, and establishing medical cost and quality control guidelines.

**Responsibilities**

- Manage pre-approval medical claims to ensure timely and accurate claim settlements

- Handle complex and high-value claims, making decisions and recommendations as needed

- Develop medical cost and quality control standards to improve claims processing efficiency

- Provide guidance, training, and support to junior claims assessors to ensure high performance

- Ensure compliance with regulatory requirements and internal policies

- Collaborate with Third-Party Administrators (TPAs) to resolve claims-related issues and identify process improvements

**Requirements**

- University degree, preferably in business, healthcare administration, or a related discipline

- Minimum 5+ years of relevant life insurance claims experience, with at least 2 years in a managerial role and TPA relationship management experience

- Excellent leadership skills

- Proficiency in data analysis and reporting

- Strong communication and interpersonal skills

- Quality assurance experience

- Knowledge of medical terminology and procedures

- Knowledge of regulatory requirements and compliance standards in the insurance industry

**Benefits**

- 5-day workweek

- Attractive salary

- MPF

- Group life and group medical insurance

- Excellent career development opportunities

## Skills

### Required
- leadership
- data analysis
- communication
- medical terminology
- regulatory compliance
- quality assurance

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Source: [Apply at sunlife.wd3.myworkdayjobs.com](https://sunlife.wd3.myworkdayjobs.com/en-US/Experienced-Jobs/job/Hunghom-Kowloon-Hong-Kong/Manager-I--Claims-Services_JR00128219-2?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)