Job Responsibilities:

• Monitor and enhance claims processing and ensure the claims service turnaround time to reach the Company requirement;
• Improve team’s claim assessment quality and decrease the mistake rate to make claim assessment more professional and impose prompt corrective action wherever necessary;
• Healthcare Network Management;
• Monitor Service Providers’ performance and fees and communication with relative party in case there is deviation found;
• Conduct analysis on claims & provider network data and produce regular reports for clients and management’s review;
• Initiate claims & provider network system enhancement for continuous improvement and carry out relevant projects;
• Participate in service review meetings with client groups or healthcare providers, attend staff benefit briefing sessions and conduct site visit at provider facilities as required;
• Handle complaints and enquiries from policyholders, insured members, brokers, agents and medical service providers;
• Monitor and supervise subordinates to manage efficiency;
• Provide training courses to new staff and other staff;
• Report and discuss with Senior Manager on claims abuse & fraud cases;
• Coordinate with Emergency Assistance Provider on overseas emergency evacuation cases;
• Consult with Medical Consultant on claims appeal or abuse cases;
• Handle claims shortfall recovery and work with Credit Control team;
• Handle re-insurance recovery;
• Other ad hoc projects as required and assigned.

Job Requirements:

• Degree holder or above with minimum 8 years' relevant working experience preferably in the insurance or banking industry, at least of 3 years of which is in a management position;
• Possesses relevant insurance professional qualification such as ACII, ANZIIF, FLMI, FLHC, etc.
• Independent, self-motivated, a good team player and able to work under pressure
• Excellent command of both spoken and written English and Chinese
• Good communication and negotiation skills
• Proficiency in Microsoft Word / Excel / PowerPoint / Chinese word processing

We offer excellent career prospects and attractive remuneration package to the right candidate. Please mark "Private & Confidential" on the envelope/e-mail in submitting your full resume covering specific achievements, availability, present and expected salary to HR Department of Blue Cross (Asia-Pacific) Insurance Ltd, 29/F, BEA Tower, Millennium City 5, 418 Kwun Tong Road, Kwun Tong, Kowloon or Fax 3608-2918 or via E-mail hrd@bluecross.com.hk.

Personal Data provided by applicants will only be used for recruitment purposes and be treated in accordance with the Company's Privacy Policy Statement, which is available on our website. Applicants who are not invited for interview within six (6) weeks may consider their application unsuccessful. The Company will retain their applications for a maximum period of six (6) months and may refer suitable applicants to other vacancies within the Company.