• Support the daily operations of the Pre-Assessment and Claims functions
• Fixed hour working on Mon to Fri (Sat & Sun off)
• 1 year renewable contract

Job Description:

• Support the daily operations of the Pre-Assessment and Claims functions, including medical pre-approval, claims adjudication, and administration, ensuring accuracy, efficiency, and compliance with internal guidelines and SOPs
• Assess medical cases and evaluate pre-approval requests with sound judgment to ensure appropriate and timely decisions
• Handle and resolve customer complaints and disputes professionally, including escalated or complex cases
• Communicate with hospitals, clinics, and other healthcare providers to follow up on medical reports, treatment details, and case status to facilitate timely processing
• Collaborate with internal stakeholders to deliver consistent, high-quality, and customer-oriented claims services
• Provide guidance and on-the-job support to junior team members to maintain service standards
• Execute ad hoc tasks and assignments as required by management to support departmental objectives

Requirements:

• University degree holder
• Minimum 5 years of relevant experience in insurance, healthcare, or claims operations, with supervisory experience preferred
• Solid experience in medical pre-approval, pre-assessment and claims adjudication
• Good understanding of medical terminology and healthcare practices
• Healthcare background (e.g., Registered Nurse or allied health professional) is preferred but not mandatory
• Proficiency in MS Word, Excel, PowerPoint, and Chinese Word Processing
• Strong command of spoken and written English and Chinese (Cantonese and Mandarin)
• Strong interpersonal, communication, and problem-solving skills, with the ability to handle sensitive cases
• Able to work independently, manage multiple tasks, and perform effectively under pressure