The Opportunity:
As a Medical Claims Officer, you will be responsible for the accurate and timely assessment and processing of medical insurance claims. You will play a vital role in ensuring our policyholders receive the support and benefits they are entitled to, directly impacting their experience during times of need.
Key Responsibilities:
Assess, verify, and process medical insurance claims (e.g., inpatient, outpatient, hospitalisation, surgical procedures) in accordance with policy terms, conditions, and company guidelines.
Review medical reports, invoices, and other supporting documents to determine claims eligibility and quantum.
Liaise and communicate effectively with policyholders, medical service providers (hospitals, clinics), agents, and other internal departments to gather necessary information and resolve claims-related inquiries.
Provide professional and empathetic responses to claims inquiries and complaints, ensuring a high level of customer satisfaction.
Maintain accurate claims records and ensure all claims activities comply with regulatory requirements and internal procedures.
Support continuous improvement initiatives within the claims department to enhance efficiency and service quality.
Who We Are Looking For:
Experience: 1-2 years of proven working experience in medical claims handling within an insurance company is essential.
Knowledge: Solid understanding of medical insurance products, claims assessment processes, and medical terminology.
Analytical Skills: Strong analytical and problem-solving abilities to assess complex medical information and make informed claims decisions.
Communication: Excellent written and verbal communication skills in English and Chinese (Cantonese is required; Mandarin is a plus).
Customer-Centric: A strong customer service mindset with empathy and patience.
Detail-Oriented: Meticulous attention to detail and accuracy in processing.
IT Proficiency: Competent in using Microsoft Office applications (especially Excel) and claims management systems.
Relevant insurance qualifications (e.g., IIQE Paper 1 & 2) are often preferred.
What We Offer:
A stable and supportive work environment within a well-established insurance company.
Competitive remuneration package and comprehensive benefits.
Opportunities for continuous learning and career development within the claims function.
A chance to make a tangible difference in policyholder's lives.
