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Medical Claims Officer

Gemini PersonnelHong Kong, China

12 天前

职位描述

Introduction :

Our client, a Medical Insurance Company is looking for a high calibre candidate to fulfill the above-mentioned position. Details are as followings :

Responsibilities :

Adjudicate claims according to policyholders policy provisions and approves claims up to allowable limit of approval in a professional and effective manner within the turnaround time;
Handle GOP request from insured, brokers, network facilities or emergency assistance company for outpatient and inpatient cases;
Cooperating with emergency assistance company for emergency cases during and outside of office hours;
Handle inquires and complaints from regional offices and Customer Services Department;
Handle outgoing claims advice to customers, brokers and regional offices;
Coordinating with regional offices and Finance Department in delivery of claims payment to client and medical providers;
Monitor claims input by regional offices;
Assist Claims Manager to undergo UAT in system enhancement;
Carry out ad-hoc duties as assigned by the Company.

Requirements :

Tertiary education or above;

3-4 years Claims management experience;

Fresh graduate is welcome. Candidate with less experience may be considered for the position of Assistant Claims Officer;

Knowledge in insurance principles;

FLMI and / or medical knowledge would be an asset;

Good communication skills with fluency in spoken and written English;

Good PC skills in MS Word and Excel.

Officer • Hong Kong, China