Assistant Manager, Claims (Group Medical)

Role Summary

Bowties mission is to make insurance good again and our vision is to build a category-defining health insurance company.

We are seeking an Assistant Manager Claims (Group Medical) to join our Claims team. This person will play a pivotal role in ensuring efficient accurate and customer-focused claims handling for our group medical business. The role suits a practical detail-oriented professional who thrives in a fast-paced collaborative environment and is committed to delivering excellent service to corporate clients and members.

About the Role

The Assistant Manager Claims (Group Medical) will support end-to-end claims operations for group medical accounts. You will manage day-to-day claims assessment and processing liaise with clients brokers and healthcare providers drive process improvements and ensure compliance with internal policies and regulatory requirements. This role involves supervising claims handlers mentoring junior staff and contributing to cross-functional initiatives to enhance claims experience and operational efficiency.

Your Key Responsibilities Include:

• Manage and adjudicate group medical claims ensuring timely accurate and fair determination in line with policy terms and company guidelines

• Oversee the end-to-end claims workflow for assigned portfolios including triage investigation approval and payment authorisations

• Review complex or high-value claims escalate appropriately and coordinate with clinical legal or underwriting teams as required

• Build and maintain strong relationships with corporate clients scheme administrators brokers and healthcare providers to facilitate smooth claims resolution

• Coach lead and develop a small team of claims handlers; allocate workload and monitor performance against SLAs and KPIs

• Identify process bottlenecks and partner with operations and technology teams to implement improvement initiatives that enhance efficiency and customer experience

• Ensure compliance with regulatory requirements internal controls and audit expectations; prepare documentation and reports for internal review

• Analyse claims trends and produce insights to inform product pricing and risk management decisions

• Support claims-related projects and change programmes including testing new processes or system enhancements

About you

• Minimum 35 years experience in medical or group health insurance claims with hands-on experience in claims adjudication and operations

• Previous experience managing or supervising a small team; demonstrable coaching and people-management skills

• Strong understanding of group medical policy terms exclusions benefit schedules and third-party arrangements

• Excellent communication skills in English; Cantonese and/or Mandarin proficiency is an advantage

• High attention to detail sound judgement and the ability to make balanced decisions under pressure

• Analytical mindset with experience using data to drive improvements; comfortable with claims metrics and reporting

• Proactive collaborative and customer-centric approach with a commitment to continuous improvement

We Offer

Apart from a great career path and an opportunity to do good and do well we also offer:

• Competitive package

• Flexible work arrangement

• Benefits include medical/dental coverage and wellness programmes

• Employee discounts

• Fun co-operative and flexible startup culture

• Weekly sharing sessions and regular social gatherings

• Excellent learning opportunities with Professional Development Sponsorship

About Bowtie

We are the first licensed virtual insurer (虛擬保險公司) in Hong Kong.

We believe that insurance is fundamentally good and we are here to bring the good back through our passionate innovative and customer-centric team.

By combining our deep domain expertise and our own proprietary modern technology we are building one of the most iconic category-defining health insurance companies in Asia.

We take pride in moving fast all the time and our track record in moving ahead in the game. Our digital insurance platform is also ranked #2 in the world in Sia Partners 2023 report.

As we grow were always looking for highly dynamic hands-on and passionate talent to join our team. If you are looking for a rewarding career where you will grow together with strong talents from different backgrounds and build products and services that bring a positive impact on the lives of millions of people in Hong Kong / Asia apply to our opening today!

Information collected will be treated in strict confidence and used solely for recruitment purposes.

The company will retain all applications no longer than 24 months of which will be destroyed thereafter.

We are an equal-opportunity employer. We do not discriminate on the basis of race sex disability or family status in the employment process.