Manager I, Claims Services

Sun Life Financial, Inc.

Hong Kong

Presencial

HKD 600.000 - 900.000

Jornada completa

Hace 9 días

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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 Financial, Inc. in Hong Kong is seeking an experienced claims leader to specialize in pre-approval medical services for cashless claims, oversee junior reviewers and establish cost and quality guidelines.

You will manage pre-approval medical claims, handle complex cases, train staff, ensure regulatory compliance, and collaborate with TPAs to streamline processes and drive improvements. The role offers a 5-day work week and attractive benefits including MPF, group life and group medical

Formación

  • University degree in business or healthcare administration.
  • 5+ years life insurance claims experience, with 2+ years in a managerial role.
  • Experience managing TPAs and relationships.

Responsabilidades

  • Manage pre-approval medical claims to ensure timely settlements.
  • Review complex/high-value claims and provide guidance.
  • Develop medical cost and QA standards to improve processing.
  • Coach junior assessors and ensure regulatory compliance.
  • Collaborate with TPAs to resolve issues and drive improvements.

Conocimientos

Leadership
Data analysis
Regulatory compliance
Communication
TPA management
Quality assurance

Educación

University degree

Descripción del empleo

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

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.

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

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