Senior Claims Manager - Pre-Approval & Quality Control

Sun Life Financial, Inc.; 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 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

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