Job Responsibilities and Expectations:
- Assist in validating and processing health insurance claims in accordance with Insurance Authority (IA) guidelines.
- Ensure accurate data entry and documentation of claim details in the claims management system.
- Support the review of claims for completeness and compliance with policy terms and conditions.
- Coordinate with internal departments to gather missing documentation or information.
- Flag potential discrepancies or anomalies for further review.
- Maintain confidentiality and data protection standards in handling sensitive health information.
- Respond to basic inquiries from policyholders regarding claim status and documentation requirements.
- Ensure timely processing of claims to meet service level agreements (SLAs).
- Assist in generating reports for internal tracking and audit purposes.
- Stay updated on changes in claims procedures and regulatory requirements in Hong Kong.
- Support continuous improvement initiatives in claims processing workflows.
- Participate in training sessions related to claims systems and regulatory updates.
- Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines.
- Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text.
- Ability to succinctly collect information from a customer to set up a new claim.
- Ability to gather information from multiple source systems to understand and articulate the status of a claim – and what information may be needed, next steps in processing, etc.
Academic and Additional Qualifications Needed:
- Bachelor’s degree in insurance, Business Administration, Healthcare Management, or related field.
- Basic understanding of health insurance products and claims lifecycle.>
- Proficiency in Microsoft Office and claims management software.
- Strong attention to detail and organizational skills.
- Fluency in Cantonese, Mandarin, and English (speak, read, and write).
About Cognizant:
Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant.