Description

Mandatory Skill:

• Cantonese language speaking and reading fluently
• Medical/Health Insurance domain
• Claims operations

Job Description:

The Supervisor supports the Quality Assurance & Training Assistant Manager in overseeing the Claims Excellence Team. This role is responsible for ensuring that post-payment claim reviews are completed within the established Service Level Agreements (SLAs). The Supervisor also assists in delivering training programs to the offshore team.

This position requires advanced knowledge of medical claims processes and the ability to identify potential risks or quality issues. The Supervisor is expected to recommend and implement corrective training measures to prevent recurrence of identified errors.

1. Assist the Assistant Manager/Manager in training and management of the offshore team to ensure operational efficiencies and effectiveness
   2. Provide ongoing training to Offshore Claims Team and ensure that claim guidelines (as set by Bupa HK) are followed and executed efficiently
   3. Review of offshore team's quality assurance checking to ensure that claim guidelines and practices provide by Bupa HK are delivered effectively and upgrading the service quality of the offshore Claims Team (including technical knowledge and servicing skills)
   4. Working collaboratively with Bupa HK Claims Excellence team to ensure that SLA error rates are within the benchmark as set by Bupa HK and report any breaches immediately to Claim Excellence Bupa HK team for handling
   5. Organizing various kinds of core training events and team / culture building activities

Desired Professional Experience:

1. With 5 years of experience in medical claims processing (Both inpatient and outpatient) with 1-year supervisory experience

2. Experience in Claims Quality Assurance is preferred

3. Customer-oriented with excellent communication and interpersonal skills

4. Strong team player, willing to learn, able to work independently and under pressure

5. Self-motivated, analytical and detailed minded in problem solving

6. Good sense of responsibility with high level of integrity and trust

Cog2025