Medical Claims Specialist (Pre-authorisation) 30-38K | 人才服務辦公室

職位描述

WallStone Partners has been dedicated to excellence in providing executive search consulting to the international companies based in operating from Hong Kong & Asia. Our reputation is based on our successful track record, creative and consultative approach, and commitment to quality, integrity and professionalism as well as an ability to develop enduring, effective working relationships.

My client is a top international insurance company, currently they are seeking talented Claims Specialist (Medical) to drive their business.

Job Description:

Responsible for handling and approving medical claims based on delegated claims authority in accordance with the established procedures and guidelines.

Responsibilities:

• Process pre-authorisation and pre-assessment cases according to the policies and guidelines;
• Process clinical operation and day case claims based on delegated claims authority in accordance with the established procedures and guidelines;
• Handle enquiries and complaints from both external and internal parties;
• Identify and investigate suspicious / fraudulent claims, and escalate cases to supervisor(s) where appropriate;

Requirements:

• Diploma holder or above in any disciplines with minimum 5 years of relevant experience in medical claims, customer services or complaint management
• Professional qualification in FLMI, FLHC, etc. will be an advantage
• Familiar with operation of medical claims and healthcare network providers
• Good communication and interpersonal skills

Interested parties, please click on below button “Apply Now”. For a confidential discussion, please contact Andy Ho at (852) 2562 8611/ Whatapps 9168 6129.