Claims Auditor - Hong Kong, 香港 - Marsh McLennan Companies

描述

Description:

The Role: Quality Assurance Analyst

The main task of this position is to ensure the quality of customer service, accuracy of claims assessment and review the claims operations process according to established procedures. The role also involves providing a wide range of account servicing support to Mercer employee benefits clients, including coordinating with clients, consultants, and insurance companies on medical claims administration activities and client inquiries.

What We Will Rely on You for:

• Audit/monitor performance of Service Delivery Team, covering Contact Centre claims related inquiries and claims input/adjudication/reimbursement/reconciliation
• Prepare analytical audit results periodically to identify risks and areas for improvement
• Handle claims related complaints escalation
• Support policy renewal
• Review existing process flow and recommend areas for improvement
• Collaborate with the processing team lead to provide various training programs to the Service Delivery Team
• Coordinate between the Service Delivery Team and Hong Kong Health Business Team
• Support claims administration of VIP accounts

What You Need to Have:

• Post-secondary diploma/degree or higher
• 3+ years of experience in medical claims adjudication
• Understanding of insurance policies and claims principles
• Ability to prioritize, meet deadlines, and handle multiple tasks
• Proficiency in spoken and written English
• Excellent skills in MS Office, especially Excel and Access
• Experience in customer service contact center and/or QA processing is a plus