Claims Assessment Manager

2 days ago

Thành phố Hồ Chí Minh, Vietnam Manulife Full time

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

**Responsibilities**:

- Delivering excellent judgment, prompt, accurate claim assessment and excellent service to Healthcare claims in accordance with Claims Department’s guidelines and procedures;
- Managing of TPA in claims assessment to meet Service Level Agreement (SLA), control quality of claim assessment;
- Proposing, initiating and managing operations of team to ensure the team’s activities smoothly executed in accordance with the Company principle and guidelines; monitoring quality and productivity of Claims staff to ensure fast and accurate assessment as Claims guidelines and cost efficiency. This team is setup as a foundation of Core Healthcare members to support building Healthcare services;
- Recruitment and providing training courses to team members to ensure the skills and knowledge developed effectively;
- Assessment claims as per prescribed authority limits; resolving complex claims and/or developing recommended solutions based on good judgment, initiative and technical skills;
- Building and maintaining excellent relationship with hospital, clinic networks and government offices, managing the Hospital/clinic and TPA/partner networks to provide excellent and effective service to customers;
- Duties to support Division targets and Company objectives as and when assigned by Line Manager;
- Cooperation with other Departments such as CS, Underwriting, IT, Agency... etc. to smoothly solve all claims-related issues and reach claims objectives.

**Job specification**:
1. EDUCATION / TRAINING

University Degree; English intermediate is preferred

2. PROFESSIONAL / TRADE QUALIFICATION

Insurance, Business

3. COMPETENCIES

Honesty, carefulness, hard-working, be able to work under high pressure

Critical thinking; Problem solving skill; People management; Project management

4. EXPERIENCE

Having experience at least 5 years in insurance and at least 3 years in Healthcare insurance

Medical Knowledge is a plus

Experience in negotiation with Medical Facility representatives to expand Panel Network

5.COMPUTER PROFICIENCY

MS Office

6. KEY WORKING RELATIONSHIP

Good attitude and respect colleagues

Team work

**About Manulife and John Hancock**

**Manulife is an Equal Opportunity Employer**

**Working Arrangement**

In Office

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