Manager, Claim Processing

PURPOSE
- Lead Claims Processing Team to fulfil all KPIs of Claims Processing team;
- Build procedural manuals for Claims Processing on daily operations to bring good experiences to customer on claim services;
- Support Claims Head in communication with Sales Force and other departments to handle daily operations.
KEY ACCOUNTABILITIES
- Collaborate with TPA in Claims Processing activities to process all claim cases relating to H&S and Reimbursement products. Follow up TPA's quality and all reports;
- Set up practices, procedural manuals for Claims Processing on daily operations to bring good experiences to customer on claim services;
- Support to build up and improve Claims workflow to help daily operation of faster, more accurate and convenient;
- Support Claims Head to review and revise claims forms, letters, payment … to improve TAT, NPS;
- Contribute Claims opinions to build T&C of new products;
- Review a sample of and put initial signature on manual letter including Declined Letter and major claim letter;
- Authorize payment voucher;
- Support Claims Head in communication with Distribution channels;
- Handle claim complaints effectively in line with company guidelines and give customer satisfaction; Manage the quality of regular/ad hoc reports to highlight any trends, impacts, issues on claim to senior management;
- Provide clear communication to customers through claim process from claim submission to claim decision/ payment and handle distribution channel issues;
- Other tasks as assigned.

HealthCare
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Insurance Claims, Claims Handling, Process Improvement, Reporting, Life Insurance