Senior Process Executive

4 weeks ago

Melbourne, Victoria, Australia Buscojobs Full time

Senior Process Executive - Claims Excellence - Health Insurance

We are seeking a dedicated Senior Process Executive to join our Claims Excellence team in the health insurance sector. The role involves validating and processing health insurance claims in compliance with Insurance Authority (IA) guidelines, ensuring accurate data entry, and supporting claims review for completeness and policy adherence.

Key Responsibilities:

  • Validate and process health insurance claims according to IA guidelines.
  • Ensure accurate documentation and data entry in the claims management system.
  • Review claims for completeness and policy compliance.
  • Coordinate with internal departments to gather missing information.
  • Identify and flag discrepancies for further review.
  • Maintain confidentiality and adhere to data protection standards.
  • Respond to policyholders' inquiries regarding claim status and documentation.
  • Ensure claims are processed timely to meet SLAs.
  • Generate reports for internal tracking and audits.
  • Stay updated on claims procedures and regulatory changes in Hong Kong.
  • Participate in training sessions related to claims systems and regulations.

Qualifications:

  • 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 (spoken, read, and written).

Additional Information:

  • Seniority level: Associate
  • Employment type: Contract
  • Job function: Information Technology
  • Industry: IT Services and IT Consulting

Note: This job posting is active and not expired.

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