Claims Services Manager — Pre-Approval & Quality Control

Sun Life; Hong Kong; Sur place; HKD 600 000 - 900 000; Plein temps

Avantages offerts par ce poste

5-day work week

MPF

Group life insurance

Group medical insurance

Career development opportunities

Résumé du poste

Sun Life in Hong Kong seeks a seasoned Claims Manager to oversee pre-approval medical services and cashless claims. You will set cost/quality guidelines, mentor junior assessors, and work with TPAs to streamline processes.

Regulatory compliance and high accuracy are essential. You'll lead a team with 5+ years in life insurance claims, including managerial experience, delivering timely settlements and impactful cost controls.

Qualifications

• University degree in business, healthcare administration or related discipline.
• Minimum 5+ years life insurance claims experience, with at least 2 years in managerial role and TPAs relationship management experience.
• Excellent leadership and communication skills.
• Strong data analysis and regulatory compliance knowledge.
• Knowledge of medical terminology and insurance procedures.

Responsabilités

• Manage pre-approval medical claims to ensure timely and accurate claim settlements.
• Handle complex and high-value claims, making decisions and recommendations as needed.
• Develop medical cost and quality control standards to improve claims processing efficiency.
• Provide guidance, training, and support to junior claims assessors to ensure high performance.
• Ensure compliance with regulatory requirements and internal policies.
• Collaborate with TPAs to resolve claims-related issues and identify process improvement.

Connaissances

Leadership

Data analysis

Regulatory compliance

Medical terminology

TPA relationship management

Communication

Formation

Bachelor's degree in business or healthcare administration

Description du poste

Sun Life in Hong Kong seeks a seasoned Claims Manager to oversee pre-approval medical services and cashless claims. You will set cost/quality guidelines, mentor junior assessors, and work with TPAs to streamline processes.

Regulatory compliance and high accuracy are essential. You'll lead a team with 5+ years in life insurance claims, including managerial experience, delivering timely settlements and impactful cost controls.