Job Description

Health Claims Operations Associate Director 

 Job Summary:

This job has direct responsibility for planning, managing and controlling staff in responsible area to achieve the target efficiency and productivity as well as responsible for claim processing by determining the validity of claims, identifying the needs for further investigation and following claims through settlement in accordance to claims processing guidelines to achieve productivities and service commitment

Key Responsibilities:  

  • Be a member of Health Strategy Management (HSM) Claim Operations Core Management, in-charge of HS claim operational planning and claim admin for corporate solution business (CS), both fax and normal claim
  • Provides leadership, development and mentoring of the Claims Management and staff by creating a culture of high performance that is driven by strategic objectives, service excellence and the company’s goals
  • Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims processing and provider inquiries (written or verbal)
  • Manage and supervise outsourced or contracted staff for CS health claim processing.
  • Assist HSM Claim Ops Head in claim process improvement and staff capacity planning
  • Assist HSM Claim Ops Head in strategic and action planning as per CS claim admin.
  • Be the key BCP contact for HS claim ops.
  • Be risk owner for CS health claim admin, fax and normal claims 

Job Requirements: 

  •   University degree in Medical Science or related field.
  • At least 8-10 years’ work experience in claims operations from Life Insurance Business.
  • Good interpersonal & communication skills both orally and in writing.
  • Good English proficiency and knowledge in using Microsoft Office.
  • Good analysis, problem solving and decision-making skills for complex issues.
  • Good supervisory and management skill.
  • Work well under pressure 

More Jobs at AIA Follow Company

See all jobs at AIA

Some similar jobs