Job Summary: The Senior Claims Analyst is responsible for the accurate and timely processing of medical claims according to policy provisions and standard operating procedures while meeting individual and team goals that are aligned to the service level agreement with the business unit.
Key Accountabilities:
1. Input, analyze and determine the amount payable of medical claims made by Manulife Hong Kong Policyholders based on policy provisions and operating guidelines 2. Ensure completeness of all submitted documents and obtain missing information and invoices from medical providers as necessary 3. Issue correspondence to policy holders within a tight timeline
Other/s: 1. Ensures accuracy of information entered in the system 2. Render overtime as required and mandated by management and Business Unit
Minimum Skills Requirement to Hire
1. Bachelor’s Degree in related field 2. Medical knowledge 3. LOMA 280&290 or other related certificates are preferred. 4. 3+ years relevant working experience in Life & Health insurance Claims 5. Basic to intermediate proficiency in English language (verbal and written) such as CET-4. Fluent speaking is a plus. 6. Knowledgeable in basic Microsoft applications such as Word and Excel 7. Excellent comprehension, analytical, problem-solving and decision-making skills 8. Good interpersonal and communication skills (both verbal and written) 9.Share knowledge of the solutions being developed with the wider team. Arrange trainings if needed. 10.Act as a QA to focus on timeliness and quality
Required key attributes: 1.Commitment to handling private and confidential information with a high degree of professionalism 2.Good understanding of claims processing and adjudication, resulting to consistent achievement of all relevant metrics 3.Good attendance management skills 4. Strong organizational skills and able to multi-task even under pressure 5. Working knowledge and understanding of company policies and work rules 6. Has excellent customer service skills and accountability for customer requests or issues 7. Fast learner