Senior Officer, Medical Service

Job description

FIND YOUR 'BETTER' AT Blue Cross We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us. We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.

If you believe in better, we’d love to hear from you. About the Role

• Assess and settle group health insurance claims arising from policies in force
• Make recommendations on policies and guidelines to group health insurance claims
• Liaise with solicitors and other third parties during investigation and negotiation to seek guidance on the course of action that serves the best interest of AIA
• Process all group health insurance claims documents timely

Answer inquires relating to claims processing Responsibilities

• Handle enquires from internal & external customers, provide solutions and information within standard turnaround time
• Manage dispute and complaint related to network service in accordance with the established procedures and guidelines
• Maintain update of network system and its administration
• Collaborate with operation teammates to ensure requests or enquiries being addressed in professional way.
• Identify and investigate suspicious / fraudulent claims including escalation to superior(s) Assist in system enhancement and workflow revision to meet our customers’ needs and services standards Backup other teams in reaching Company’s services standard; Handle ad-hoc duties as assigned by superior(s)

Job Requirements

Diploma holder or above in any disciplines Minimum

• 5 years relevant experience in medical claims, customer services or complaint management Professional qualification in FLMI, FLHC, etc. will be an advantage Familiar with operation of medical claims and healthcare network providers Good communication and interpersonal skills Detail-minded with strong sense of responsibilities and well-organized Flexible and customer-oriented Able to handle multi-task and work under pressure in a fast paced environment Good command of both written and spoken

English and Chinese

• Proficient in MS Office and Chinese Word Processing
• Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.