Assistant Manager - Claims Management

The incumbent will help with day-to-day communication with network providers for claims operations.  This includes communication regarding checking of benefit eligibility of members/customers via electronic feed, coordinating system testing with network providers when new system process launched and reconciliation of provider claims payment settlement via electronic mean. 

Job Responsibilities:

• Process medical Pre-approval and Claims in compliance with policy provision and benefits
• Handle case management for entire claims journey to customer
• Comply with medical guidelines and provide quality work effectively and efficiently
• Liaise with medical professionals and healthcare provider to conduct Pre-approval and Claims assessments or investigation  

• Handle related Pre-approval and Claims enquiries from customers, brokers or relevant parties
• Support manager to implement initiatives to improve claims performance
• Maintain positive relationship with all stakeholders 

Job Requirements:

• Degree / Diploma holder or equivalent working experience
• At least 5 years of experience in medical Pre-approval and Claims processing
• Experience in handing medical Pre-approval and Claims
• Relevant medical knowledge is an advantage
• Customer-oriented with excellent communication and interpersonal skills.
• Strong team player, willing to learn, able to work independently and under pressure
• Good command of English and Chinese in both written and spoken
• Proficiency in MS Office applications including Word, Excel and Chinese word processing

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.