Claims Officer

Job description

Job Accountabilities

To ensure claims procedures, documentation is adhered to the group claims management requirement and best practice To take proactive approach in monitoring employees’ compensation claims in order to minimize claims settlement To conduct in-house global settlement or be able to guide team to conduct in-house global settlement To build up relationship with all stakeholders and achieve compromised settlement to conclude the case at the earliest time and avoid litigation

To meet with clients for claims review meeting To work with our healthcare specialist in minimizing claims duration To report to claims management team on adverse trend of development of claims To report to claims management team for clients with adverse claims experience To assist Claims Manager to monitor and conduct assessment of the performance of external loss adjuster whose services form part of claims services

To provide quality customer service to clients To ensure all claims are processed effectively according to the company policies To set and monitor reserve adequately and timely and ensure the authoritative level laid down are complied with To identify all potential recovery and fraud cases To perform any other duties, task-oriented or claims related as may be delegated by

Claims Manager Handle WC litigated claims taking responsibility to resolve all enquiries from both customer and external contacts to ensure delivery of a focused claims service.

To develop a claim case strategy to ensure appropriate reserves are assigned, investigations conducted, and appropriate suppliers engaged. Acquire and efficiently organize the relevant evidence and information to accurately assess the value of the litigated claim and to recognize potential fraud/recovery indicators. Review, resolve and proactively finalize claims within authority limits ensuring settlement at an optimum level.

Job Qualifications

Degree holder Tertiary education in one of the fields (or more) would be required: Health, Insurance, Business Administration or Legal ANZIIF/ACII would be an asset Over

• 2 years EC claims management experience is a must Experience in managing legal claims is highly preferred Previous experience in handling corporate clients would be an asset
• Knowledge in insurance principles Litigation knowledge is highly preferred
• Understand legislation and legal liability Interpretation of policy cover
• Understand industry standards and protocol
• Knowledge of claims agreements
• Knowledge of the legal procedure of EC litigated case in Hong Kong With medical knowledge would be an asset
• Strong knowledge of Employees‘ Compensation Ordinance Global settlement experience Good command of written and spoken English & Chinese (including Mandarin and/or Cantonese) Negotiation skills, both written and verbal

Job Qualifications

• Understand industry standards and protocol
• Knowledge of claims agreements