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【Job Description】
1. Assess and process claims application, involve in approving and reviewing complex, appeal and complaint cases
2. Set up claims guidelines for new products and prepare claims manual from time to time
3. Ensure the whole workflow compliance with internal control standards and regulatory requirements
4. Monitor the claims operational flow and SLA including but not limited to turnaround time, hotline service and quality of outgoing claims correspondence
5. Lead and coordinate BAU system enhancement activities to meet business priorities as well as set up Auto-Claims Rules
6. Handle enquiries and provide professional one-stop-solution to internal/external customers, which including assist in application, handle complaint and other policy services.
【Requirements】
1. University Degree holders in Insurance, Business Administration, Management or related disciplines
2. Holder of FLMI, ALHC or ICA qualification is preferred
3. Minimum 8 years of working experience individual life insurance claims
4. Experience in connecting medical network is preferred
5.Strong analytical, problem-solving, coordination, collaboration,and communication skills; attentive to details
6. Positive attitude, highly flexible, able to deliver outstanding results under challenging environment
7. Proficient in both spoken and written Chinese, English and Putonghua
8.Familiar in MS Word, Excel, PowerPoint and Chinese Word Processing
【Note】
Salary negotiable


【職位描述】
1. 審批理賠申請，並參與審閱或批核複雜、上訴及投訴案件
2.為新產品制定理賠準則，並不時更新理賠手冊
3.制定和执行理赔策略，确保理赔流程符合公司政策、行业标准和監管要求
4.领导和管理理赔团队，确保工作质量、業務操作流程、服務承諾和绩效达到预期目标
5.参与制定和改进理赔流程、自動理賠規則和系统優化工作，提高理赔效率和客户满意度
6.與内部部门、客户和代理人等相关方协调和沟通，解答他们的疑问，提供理赔相关的支持和指导
【要求】
1. 保險、工商管理或相關專業的大學學位持有者，持有 FLMI、ALHC 或 ICA 資格證書者優先考慮
2. 至少8 年人壽保險理賠工作經驗
3. 有搭建醫療網絡經驗者優先
4. 具有優秀的分析和問題解決能力、及良好的沟通和协调能力，能够与不同人员有效合作
5. 態度積極，高度靈活，能夠在充滿挑戰及高压的環境中獨立工作
6. 精通粵語、英語者優先
7. 熟練使用MS Word、Excel、PowerPoint
【備註】
薪酬面议