Senior Process Executive
2 days ago
- Review incoming health insurance applications for completeness and accuracy.
- Extract and validate medical information from application forms and supporting documents.
- Perform initial risk assessment based on predefined underwriting guidelines.
- Coordinate with internal teams to obtain missing or additional medical information.
- Ensure compliance with Hong Kongs Insurance Authority (IA) regulations and data privacy laws.
- Input and update underwriting decisions in the policy administration system.
- Refer complex or borderline cases to senior underwriters or medical officers.
- Maintain accurate documentation of underwriting decisions and rationale.
- Support the issuance of policy documents post-underwriting approval.
- Respond to internal queries related to underwriting status and documentation.
- Participate in training sessions to stay updated on underwriting protocols.
- Ensure timely processing of applications to meet service level agreements (SLAs).
- Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines
- Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text
- Ability to succinctly collect information from a customer to set up a new claim
- Ability to gather information from multiple source systems to understand and articulate the claim and what information may be needed, next steps in processing, etc.Role & responsibilities
Preferred candidate profile
- Bachelor's degree in Life Sciences, Nursing, Healthcare Administration, or related field.
- Basic understanding of medical terminology and health insurance products.
- Proficiency in Microsoft Office and insurance processing systems.
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