Adjudicate claims under different distribution channels independently and ensure the effectiveness of the claim administration processes;
Supervise subordinates to deliver the required claims service to both our internal and external customers;
Handle claim enquiries and resolve complaints from external Brokerage and internal clients;
Conduct process control / audit internally and the Network / Third Party Administrators (TPA) to ensure adherence to standards and guidelines set by Cigna and regulations;
Prepare monthly management report and ad-hoc report for claims management;
Analyze claims data to identify problem’s root causes, propose resolutions and execute improvement plans;
Work closely with internal IT and external IT vendors to report and test system issues. Identify opportunities for system enhancements and perform full cycle UAT to ensure successful production;
Support product development and sales function by conducting claims training for both internal and external parties.
Handle ad hoc projects and duties.
Diploma or above, preferably with insurance-related qualifications, e.g. FLMI, ICA;
At least 5 years’ experience in claims adjudication / administration of which at least 2 years in supervisory role;
Experience in working or managing the Network / Third Party Administrators (TPA) is highly preferable;
Proven track record of working with IT, vendors and stakeholders on developing user requirements and test cases for system, and conducting UAT;
Good team player, able to work independently and under pressure;
Possess customer centricity mindset;
Good command of both English and Chinese.