Claims Officer, OPC
QBE Insurance Group
HKG - Quarry Bay
9天前

Provide timely delivery, accurate claims service and processing support to the business on high volume, low impact (Fast Track) claims.

Determine proper policy coverage to conclude, evaluate and negotiate assigned cases

The responsibilities

  • Handle claims within delegated authority according to company policies
  • Handle Employee Compensation Insurance claims within delegated authority according to company policies
  • Maintain daily operations of the team to ensure consistent, accurate and fair claims processing in a high level of integrity
  • Quickly respond to and resolve complaints within the agreed service standards. Take immediate corrective actions when necessary
  • Upkeep the claim status and undertake periodical reviews
  • Generate claims reports to facilitate the manager for analyzing the portfolio
  • Encouraging and monitoring client compliance with approved treatment and plans
  • Managing and negotiating cost effective treatment and rehabilitation
  • Interpret basic policy coverage's and determine if coverage's apply to claims submitted, escalating issues as needed
  • Identify suspicious or potentially fraudulent claims, notify supervisor
  • Complete the preparation, data entry and authorisation of all payments pertaining to claims
  • The requirements

  • Tertiary graduate with professional qualifications in insurance or related disciplines
  • At least 1 - 2 years experience in insurance
  • Fundamental knowledge of insurance industry and claims processes
  • Working knowledge and understanding of employees’ compensation and / or case management
  • Strong analytical, negotiation and interpersonal skills
  • Able to work independently and meet service standards
  • Customer-centric and proactive attitude
  • Good command of spoken and written English and Chinese
  • Proficiency in PC
  • Candidates with less experience may be considered. Fresh grads also welcome
  • Number of Openings :

    Equal Employment Opportunity :

    QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

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