Final Claims – Health Insurance Claim Operations
Full Time, Work from Office
Coimbatore
Posted 7 months ago
- Review processed claims for accuracy and compliance with Hong Kong’s Insurance Authority (IA) regulations.
- Conduct audits on claim adjudication decisions and identify discrepancies.
- Ensure adherence to internal quality benchmarks and turnaround times.
- Collaborate with processors to provide feedback and training on claim handling procedures.
- Document quality issues and recommend corrective actions.
- Assist in updating SOPs based on regulatory changes and audit findings.
- Support fraud detection efforts by identifying unusual claim patterns.
- Coordinate with compliance teams to ensure regulatory alignment.
- Prepare quality reports and dashboards for management review.
- Participate in internal and external quality assurance reviews.
- Ensure data accuracy in claim systems and documentation.
- Mentor junior staff on quality standards and best practices.
Job Features
| Job Category | IT, Non-IT |
| Experience | 3 to 15 Years |
| Skills | Health insurance claim operations |
| Primary skills | Health insurance claim operations |
| Education | • Bachelor’s degree in Insurance, Business Administration, or Healthcare Management. |
| Openings | 10 |
| sukanya@aimplusstaffing.com |