Manager I, Claims Services

Sun Life Hong Kong Limited; Hong Kong; Presencial; HKD 600.000 - 900.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

5-day work week

MPF

Group life insurance

Group medical insurance

Career development opportunities

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

Leadership

Data analysis

Regulatory compliance

Medical terminology

TPA relationship management

Communication

Educación

Bachelor's degree in business or healthcare administration

Descripción del empleo

About Sun Life

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful. When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description

This role will specialize in pre-approval medical services (cashless claims), involve overseeing junior case reviews and establish medical cost/quality control guidelines as well as collaborate with Third-Party Administrators (TPAs) to optimize processes.

Responsibilities

• 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

Requirements

• University degree, preferably in business, healthcare administration or related discipline
• Minimum 5+ years relevant life insurance claims experience, with at least 2 years in managerial role and TPAs relationship management experience
• Excellent leadership skills
• Proficiency in data analysis and reporting
• Strong communication and interpersonal skills
• With quality assurance experience
• Knowledge of medical terminology and procedures
• Knowledge of regulatory requirements and compliance standards in the insurance industry

Our Culture

At Sun Life, we're driven by our Purpose: to help Clients build lifetime financial security and lead healthier lives. Across Asia, we cultivate a High-Performance, Caring Culture that empowers our people to achieve outstanding results, embrace continuous growth, and create meaningful impact. We succeed together by fostering an inclusive environment where wellbeing, collaboration, and accountability are equally valued.

Benefits

We offer 5-day work, attractive salary, MPF, group life and group medical insurance; and excellent career development opportunities to the right candidate.

We are an equal opportunity employer and welcome applications from all qualified candidates.

Application forms and resume will be kept for a period of 24 months after completion of the recruitment process. (All information will be held in strict confidence and only be used for recruitment purpose).

Job Category: Claims - Life & Disability

Posting End Date: 27/12/2026

Why Join Us

Shine together At Sunlife, you can be your most brilliant self. Our supportive, flexible, and inclusive work environment is one where you - and your career - can thrive. Whatever your aspirations, collaborative leaders and colleagues are ready to help you learn, grow, and succeed. Make life brighter We're a global company with a passion for people. Our purpose is to help Clients build lifetime financial security and lead healthier lives. As a team of 68,000 across 28 markets, our impact is far-reaching, and locally relevant. There's power in numbers. As part of Sunlife's growing team, you have an impact on people in your community and around the world. Shape the future With an optimistic eye on a brighter future, we drive to innovate. Be part of leading change, push boundaries and try new ways of working. Use data to drive bold actions. Be agile and pivot as we test and learn. At Sunlife, we're driving transformation, sustainability and innovation for our Clients, employees, partners, and communities. Join us. Together, we can make the future brighter. Join a top employer for a brighter future. Visit Sunlife Careers