Job Introduction

The Case Manager Assistant will report to the Case Manager with the primary goal to review individual case management of medical cases as specified by the business to ensure balancing between high quality and cost-efficient health care is delivered to customers.

Role Responsibility

• To investigate, and response to enquiries for complex medical pre-authorization and high value claims from different internal and external shake holders including but not limited to members, providers, service providers and intermediarties in the appropriate method, in line with Bupa Gloabl policy and management style
• Ensure the correct interpretation of Bupa Global’s policies and rules, using the appropriate coding system to process the data and information accurately.
• Identify opportunities to reduce future claim expense for Bupa Global
• Proactively negotiate medical cost based on evidences to achieve either reducted cost to the buesiness
• Proactively identify fraud and/or abuse and reports to appropriate parties
• Assist Case Manager to oversee member’s progress and monitor the discharge plan drafted
• Assist Case Manager to prepare documents and reports required for internal and external shake holders in the scope of case coordination activities and/ or data collections
• Manage clinical database in form of using computer and physical file under the supervision of Case Manager
• Assist in ad-hoc project as and when required

The Ideal Candidate

• Excellent analytical, critical thinking and interpersonal skills
• Ability to work independently as well as able to contribute to the team is a must
• Highly customer focussed and able to place customer’s health and benefit in the first priority
• Respects diversity and embraces cultural differences
• Understand the business commitment to meet deadline and turn-around time
• A proficient communication skill in English and Cantonese is a must. Able to speak Mandarin is an advantage