Key responsibilities:
- Perform pre-authorization and pre-assessment procedures in accordance with established policies and guidelines.
- Handle clinical operation and day case claims within the authorized claims authority, adhering to established procedures and guidelines
- Handle enquiries and complaints from both external and internal parties.
- Determine and examine potentially fraudulent or suspicious claims, and escalate relevant cases to supervisors when necessary.
Key requirements:
- University Degree in any disciplines
- Minimum 5 years relevant experience in medical claims
- Familiar with operation of medical claims and healthcare network providers
- Good command of both written and spoken English and Chinese