Assistant Manager, General Insurance Claims

We are seeking an Assistant Manager, General Insurance Claims to join our team at Blue Cross.

As an Assistant Manager, you will be responsible for determining the validity and authorising settlement of group health insurance claims.

Key responsibilities include:

• Pro-actively handling claim cases, including timely investigation into suspicious abuse claims, cost-effectiveness engagement of service providers, regular claims follow-up, and providing guidance and coaching to subordinates on claims, insurance/risk issues, and performance;
• Assessing, handling, and approving all claims types and authorising claims payments within authority, and referring claims beyond authority to the Head of Claims/Manager with sound recommendations;
• Drafting effective correspondence for complex coverage positions;
• Handling claims appeals, complaints, reinsurance/third-party recovery claims in the best interest of the Company;
• Working with the Head of Claims/Manager to monitor and conduct assessments of service providers for effective investigation/litigation/recovery management;
• Assisting in report preparation/automation;
• Actively participating in team meetings, enhancement of workflow, claims systems, UAT, and projects;
• Interfacing with related departments and relevant parties on projects and joint work to enhance customer service experience;
• Obtaining and maintaining a license as an individual insurance agent of Blue Cross with the Insurance Authority, and advising on or arranging contracts of insurance or carrying on regulated activities where necessary.

Requirements:

• University degree with professional insurance or related disciplines plus 7 years' relevant experience; or secondary education or above plus 7 years' relevant experience with at least 3 years at supervisory level;
• Fulfilment of the fit and proper criteria of the Insurance Authority for licensing as an individual insurance agent of the Company, and minimum education and qualifications requirements, including passes in IIQE Paper 1 & 2;
• Self-motivated with the ability to multitask in a fast-changing environment;
• Sound negotiation, interpersonal, and problem-solving skills;
• Intermediate to advanced Excel skills;
• Progress in achieving ANZIIF or ACII qualification;
• Good knowledge of insurance products, relevant legal procedures, and legislation;
• Proven experience in managing complex claims and advanced insurance knowledge.