Job description

Requirements

  • Entry level
  • No Education
  • Salary to negotiate
  • HONG KONG

Description

Senior Officer, Group Admin & Medical (Claims & Underwriting Team)At Prudential, we understand that success comes from the talent and commitment of our people. Together, we have a shared vision in securing the future of our customers and our communities. We strive to build a business that you can shape, an inclusive workplace where everyone's ideas are valued and a culture where we can thrive together. Our people stay connected and tuned in to what's happening around us, keeping us ahead of the curve. While focused on the long-term, we look to the future to bring growth, development and benefit to everyone whose lives we touch.

Job responsibilities:

1. Group Administration and Medical Manager (Claims and Underwriting Team)

Job Scopes:

- To effectively manage the entire operation of claims team (Individual and Group Medical Claims)
- To ensure accurate and consistent result of inpatient and outpatient claims adjudication with regular review of claims guidelines and authority delegation
- To liaise with medical service providers to ensure comprehensive and high quality services to be offered to clients
- To handle claim disputes and complaints
- To coordinate with different stakeholders to promote company's quality services offered to clients
- To supervise underwriting team for sound risk selection
- To engage in projects to facilitate Company's sustainable development


2. Senior Group Administration and Medical Officer (Claims and Underwriting Team)

Job Scopes:

- To handle claims related inquiries and complaints from sales and customer channels
- To perform inpatient and outpatient claims adjudication and review
- To coach subordinates on inpatient and outpatient claims processing
- To supervise vendors' services delivery and ensure claims adjudication accuracy
- To participate in claims management related enhancement projects
- To assist manager in providing regular training to the team and sales force


Job requirements:

- Secondary School graduated, FLMI
- Minimum 3 years of working experience of policy administration services in medical insurance industry

  • economists and finance