Senior Officer, Claims Management

Job Responsibilities

Handle pre-approval of commercial assessment

Handle claims process, including both inpatient and outpatient medical claim

Communicate with customer on pre-approval decision

Improve the effectiveness of the claim adjudication and administration processes, with network service providers when necessary

Handle provider claim enquiries from panel network

Prepare report to management

Conduct claim assessment processes, claim investigation and to review all status and ensure efficient outcome in customer oriented approach

Meet standard of individual quality, turnaround time and productivity benchmark.

Handle project tasks and arrangement

Requirements

Diploma or above, preferably with insurance-related qualifications, e.g. FLMI, ICA

At least 3 years’ experience in claims adjudication / administration

Experience in working with pre-approval of medical claims

Good team player, able to work independently and under pressure in a fast-paced environment

Possess customer centricity mindset

Good interpersonal and communication skills

Cantonese speaker with good command of both English and Chinese

Candidate without Claims experience but with a medical-related degree will also be considered.

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.