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Claims Assessment Specialist

1 month ago

Thành phố Hồ Chí Minh, Vietnam Manulife Full time

**1. The Opportunity**:
We are looking for Claims Assessment Specialist to support Claims Manager assess healthcare claims to comply with Claims’ guidelines. In addition, you contribute as Subject Matter Expert in projects relating to enhance healthcare services. You shall work with dynamic, professional, and strong core values organization.

**2. Responsibility**:

- Supporting Manager to deliver excellent judgment, prompt, accurate claim assessment and excellent service to Health claims in accordance with Claims Department’s guidelines and procedures.
- Ensuring TPA’s claims assessment to meet Service Level Agreement (SLA).
- Working with Manager in claim services, preparation of Healthcare claims’ guidelines and procedures.
- Contribution as Subject Matter Expert in projects relating to enhance healthcare services.
- Supporting Manager to assess Healthcare claims as per prescribed authority limits; resolving complex claims and/or developing recommended solutions based on good judgment, initiative and technical skills.
- Collaboration with cross departments/functions to smoothly solve all claims-related issues and reach claims objectives.
- Duties to support Department targets and Company objectives as and when assigned by Team leader/Line Manager.
- Be in-charge of regular and ad-hoc reports for Claims Team, Claims VSO and COO.
- Take part in making user requirements for new products and testing them to make sure there are adequate features in the system for Claims users to use.
- Join projects of Claims CXT as SME role.

**3. How will you create impact?**

This role reports to Head of Health Claims. You are Claims Assessment Specialist to support team leader to assess healthcare claims for prompt, accurate assessment and excellent services to customers as well as to join as a Subject Matter Expert in health projects.

**4. What motivates you?**
- You obsess about customers, listen, engage, and act for their benefit.
- You think big, with curiosity to discover ways to use your agile approach and enable business outcomes.
- You thrive in teams and enjoy getting things done together.
- You take ownership and build solutions, focusing on what matters.
- You do what is right, work with integrity and speak up.
- You share your humanity, helping us build a diverse and inclusive work environment for everyone.

**5. What are we looking for?**
- Education: University or College degree in economics or equivalent, preferably in insurance field. English intermediate is preferred.
- Having at least 3 years in insurance. Medical Knowledge is a plus.
- Having Microsoft office, teamwork, critical thinking and problem-solving skills.
- Being careful, proactive, enthusiasm, hardworking, collaborative and honest.
- Being able to work under high pressure.
- Good attitude and respect colleagues.

**6. What can we offer you?**
- A competitive salary and benefits packages.
- A focus on growing your career path with us.
- Flexible work policies and strong work-life balance.
- Professional development opportunities.
- Values-first culture: We lead with our Values every day and bring them to life together.
- Boundless opportunity: We create opportunities to learn and grow at every stage of your career.
- Delivering the promise of Diversity, Equity and Inclusion: We foster an inclusive workplace where everyone thrives.
- Championing Corporate Citizenship: We build a business that benefits

**About Manulife and John Hancock**

**Manulife is an Equal Opportunity Employer**

**Working Arrangement**

Hybrid