JOB OPENING

Claims Administrator – Cantonese speaker

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 Supporting Country:

Hong Kong

 Location:

Hong Kong

 Vacancy ID:

VAC3507

Job Description

RESPONSIBILITIES
Ensure the qualification of cases (emails) in our Salesforce tool. Fill in cases (Salesforce emails) with the necessary information to link the email to the insured/underwriter's environment. Fill in the subject of the emails. Dispatch cases (Salesforce emails) according to the services and the organization of the management services, and close certain cases. Deliver excellent customer service through high-quality and efficient handling of policyholder claims. Understand clients' needs, eligibility, and coverage, and provide qualified assistance services accordingly. Manage cases proactively using our internal systems and communicate with all relevant departments. Formulate, affect, interpret, or implement policies pertaining to strategic claim resolution. Make prompt and timely decisions on policy cover and settlement costs. Acquire information as necessary to perform accurate redress calculations. Achieve set targets in line with required quality standards.
DESCRIPTION
We are seeking a detail-oriented and experienced Claims Administrator to join our team. The ideal candidate will have a solid background in nursing, health administration, or claims administration, and will be responsible for managing and processing insurance claims efficiently while delivering excellent customer service.
DELIVERABLES
- Assist and support claims head on project management, team management, and loss prevention. - Manage claims for Health/PA, individual and group policies. - Process Accident & Health claims according to SOPs and SLAs. - Review customer claims documents and assess eligibility based on insurance terms and conditions. - Investigate suspicious medical claims and collaborate with internal and external stakeholders. - Process claims payments to customers and hospitals in a timely manner. - Provide customer assistance and handle customer/broker inquiries. - Address complaints escalated by customer Service, Marketing, or Regulatory. - Review claims processes and propose improvements, reporting Process issues that need further development. - Oversee Claim’s customer services to ensure the best customer experience at each stage of claims.
SKILLS AND BEHAVIOURS
- Fluent in both written and spoken English and Cantonese. - Flexibility in working hours is expected. - Flexibility, adaptability, and a positive mindset are key values for this role. - Excellent communication, interpersonal, and analytical skills. - Proficient in using computers, Microsoft Office, Internet, and Email. - Strong analytical and problem-solving skills. - Ability to adapt and work well in a multicultural environment. - High level of proficiency in English and Mandarin/Cantonese. - Strong multitasking abilities.

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