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