About Company
AIA Group Limited is the largest independent publicly listed pan-Asian life insurance group, with a presence in 18 markets across the Asia-Pacific region. Established in 1919, AIA boasts over a century of experience in Asia, providing comprehensive financial solutions to millions of individuals and businesses. Our extensive range of products and services includes life insurance, accident and health insurance, and savings plans, all designed to meet the evolving needs of our diverse customer base. At AIA, we are driven by our purpose to help people live Healthier, Longer, Better Lives, fostering financial security and well-being. We are committed to nurturing a diverse and inclusive workforce, empowering our employees with opportunities for growth and development, and contributing positively to the communities we serve. Joining AIA means becoming part of a leading organization that values excellence, integrity, and customer-centricity.
Job Description
AIA Group Limited is seeking a meticulous and dedicated Healthcare Claims Processor to join our dynamic team in Hong Kong. In this critical full-time role, you will be instrumental in the accurate and efficient processing of healthcare claims, ensuring timely and fair resolution for our valued policyholders. This position requires a keen eye for detail, strong analytical skills, and a commitment to maintaining high standards of customer service and regulatory compliance. You will be responsible for reviewing, evaluating, and processing various types of healthcare claims, verifying policy coverage, medical necessity, and adherence to company guidelines and industry regulations. This is an immediate start position for an individual ready to contribute significantly to our operations and uphold our reputation for excellence in the insurance sector.
As a Healthcare Claims Processor, you will communicate effectively with policyholders, healthcare providers, and internal departments to gather necessary information, clarify discrepancies, and provide updates on claim statuses. Your ability to interpret complex medical documents and insurance policies, coupled with a compassionate approach, will be key to your success. You will navigate our claims processing systems with proficiency, ensuring all data entry is accurate and complete. We are looking for an individual who is not only detail-oriented but also possesses a strong sense of ownership and accountability. If you are eager to embark on a challenging yet rewarding career path within a leading global insurer, where your contributions directly impact the well-being of our customers, we encourage you to apply.
Key Responsibilities
- Process healthcare claims accurately and efficiently in accordance with company policies, procedures, and regulatory requirements.
- Review and verify submitted claims for completeness, eligibility, and medical necessity, identifying any discrepancies or missing information.
- Communicate professionally with policyholders, healthcare providers, and internal stakeholders to resolve queries and obtain necessary documentation.
- Investigate complex claims, ensuring proper adjudication and adherence to benefit limits and contractual agreements.
- Maintain detailed and organized records of all claim activities and communications within the claims processing system.
- Collaborate with medical advisors and other departments to facilitate claim resolution and address escalated issues.
- Ensure compliance with all relevant industry regulations, data privacy laws (e.g., PDPO), and internal control guidelines.
- Identify and report potential fraudulent claims or policy abuses.
- Continuously seek opportunities to improve claims processing efficiency and customer satisfaction.
Required Skills
- Minimum 1 year of experience in claims processing, preferably within the healthcare or insurance industry.
- Strong analytical and problem-solving skills with exceptional attention to detail.
- Excellent written and verbal communication skills in English and Cantonese (Mandarin a plus).
- Proficiency in using claims management software and Microsoft Office Suite (Word, Excel, Outlook).
- Ability to interpret medical terminology and insurance policy documents.
- Demonstrated ability to work effectively under pressure and manage multiple tasks.
- High level of integrity and professional ethics.
Preferred Qualifications
- Associate's Degree or Diploma in Business Administration, Healthcare Management, or a related field.
- Knowledge of Hong Kong's healthcare system and insurance regulations.
- Experience with customer service in a call center or administrative support role.
- Certification in insurance or claims processing (e.g., LOMA, FLMI).
Perks & Benefits
- Competitive salary and performance-based bonuses.
- Comprehensive medical, dental, and life insurance coverage.
- Generous annual leave and compassionate leave.
- Opportunities for professional development and career advancement within a global organization.
- Employee wellness programs and initiatives.
- Supportive and collaborative work environment.
- Access to a wide range of employee discounts and benefits.
How to Apply
Interested candidates are invited to submit their application by clicking on the link below. Please ensure your resume highlights your relevant experience and qualifications for this role. Only shortlisted candidates will be contacted for an interview.