Senior Manager Claims
Found in: Talent MY C2 - 1 week ago
FIND YOUR 'BETTER' AT AIA
If you believe in better, we’d love to hear from you.
About the Role
oThis position is to manage and lead Claims team to provide efficient and effective processing claims services for AIA Hong Kong Claims DepartmentPlans,manages and provide strategic initiatives to drive the performance of staff to produce most efficient and cost effective results to ensure claims are processed within the Service Level Agreement (SLA). This includes claims control management, adjudication, fraud waste & abusive implementation, claims trends analysis, training and development of claims assessors, sharing best claims practices, day to day operations of claims
Ensure all claims are processed within the SOPs established and responsible for timely delivery of claims services as per SLA agreement
•Corresponds and communicates with business partner sand or/other departments within Shared Services Malaysia to resolve or discuss matters for effective administration of claims
•Approve claims that exceed Manager authority and handle complaints
•Prepare Key Performance Indicator goals to align with department and company objectives to achieve AIA operation targets
•Study and propose revision of claims practices to better manage the claims cost.
•Actively participate in Claims control management such as reviewing of claims with high charges of surgeon fees, consultation, diagnostic test, medical necessity for hospital admission.
•Review and analyse claims trends, statistics, cost containment, etc with the intention to provide key learnings to claims assessors
•Work with managers to assure proper training, instruction development of staff as well as accomplishment of section activities
•Plan and budget for department expenses to ensure that cost are managed effectively
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