Assistant Manager - General Insurance Claims

FIND YOUR 'BETTER' AT Blue Cross

We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us.

We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.

If you believe in better, we’d love to hear from you.

About the Role

Responsible for determining the validity and authorising settlement of group health insurance claims

Duties:

• Pro-actively handle claim cases, including timely investigation into suspicious abuse claims, cost-effectiveness engagement of service providers, regular claims follow up, provide guidance and coaching to subordinates on claims, insurance / risk issues and performance;
• Assess, handle and approve all claims types and authorize claims payment within authority and refer claims beyond authority to the Head of Claims / Manager providing sound recommendations;
• Draft effective correspondence for complex coverage positions;
• Handle claims appeals, complaints, reinsurance / third party recovery claims in the best interest of the Company;
• Work with the Head of Claims / Manager to monitor and conduct assessment of service providers for effective investigation / litigation/ recovery management;
• Assist in reports preparation / automation;
• Actively participate in the team’s meeting, enhancement of workflow, claims system, UAT and projects;
• Interface with related departments and relevant parties on projects and joint work to enhance customer service experience;
• Obtain and maintain license as an individual insurance agent of Blue Cross with the Insurance Authority, and, where necessary, upon successful licensing as individual insurance agent with the Insurance Authority, advise on or arrange contracts of insurance or carry on regulated activity.

Education/Work Experience

• University degree with professional insurance or related disciplines plus 7 years’ relevant experience; or secondary education or above plus 7 years’ relevant experience with at least 3 years at supervisory
• Fulfilment of the fit and proper criteria of the Insurance Authority for licensing as an individual insurance agent of the Company, and the minimum education and qualifications requirements, including but not limited to passes in IIQE Paper 1 & 2 ;
• Self-motivated with the ability to multitask in a fast changing environment;
• Sound negotiation, interpersonal and problem-solving skills;
• Intermediate to advanced Excel skills.
• Progress in achieving ANZIIF or ACII qualification;
• Good knowledge of insurance product, relevant legal procedures and legislations;
• Proven experience in managing complex claims, and advanced insurance knowledge.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

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