Senior Process Executive

3 weeks ago

Melbourne, Victoria, Australia Cognizant Full time
Senior Process Executive - Claims Excellence - Health InsuranceSenior Process Executive - Claims Excellence - Health Insurance

2 days ago Be among the first 25 applicants

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  • 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).
Seniority level
  • Seniority levelAssociate
Employment type
  • Employment typeContract
Job function
  • Job functionInformation Technology
  • IndustriesIT Services and IT Consulting

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