Manager I, Claims Services

You are as unique as your background experience and point of view. Here youll be encouraged empowered and challenged to be your best self. Youll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day youll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals families and communities around the world.

Job Description:

This role will specialize in pre-approval medical services (cashless claims) involve overseeing junior case reviews and establish medical cost/quality control guidelines as well as collaborate with Third-Party Administrators (TPAs) to optimize processes.

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 TPAs to resolve claims-related issues and identify process improvement

Requirements

• University degree preferably in business healthcare administration or related discipline

• Minimum 5 years relevant life insurance claims experience with at least 2 years in managerial role and TPAs relationship management experience

• Excellent leadership skills

• Proficiency in data analysis and reporting

• Strong communication and interpersonal skills

• With quality assurance experience

• Knowledge of medical terminology and procedures

• Knowledge of regulatory requirements and compliance standards in the insurance industry

We offer 5-day work attractive salary MPF group life and group medical insurance; and excellent career development opportunities to the right candidate.

We are an equal opportunity employer and welcome applications from all qualified candidates. Application forms and resume will be kept for a period of 24 months after completion of the recruitment process. (All information will be held in strict confidence and only be used for recruitment purpose).

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