Healthcare Assessment Claims
TP. Hồ Chí Minh
Application deadline:
31/10/2026
About This Job
Trách nhiệm chính
- Manage all aspects of the claim process
- Adjudicate non-complex claims according to established guidelines and standards as well as state legislation
- Determine appropriate requirements
- Analyze and interpret claim documentation, policy contract wording and in-force policy documentation to establish whether the claim is complete and valid, correct death benefit and correct beneficiary
- Make claim decisions within approval limits
- Make disbursements on valid claims to the correct beneficiary for the correct claim amount
- Communicate and collaborate with the field and head office colleagues to provide the highest quality and service levels to customers
- Handle other issues or requirements related to the claim such as check stop pay and reissue
- Ability to adapt to changing regulatory requirements affecting claim practices and apply new approaches
- Specifically, claims and endowments; annual due diligence address cleanse, process pre-escheatment claim payments
- Process accounting as required Assist in identifying and providing solutions to work related problems and issues (ie. work flow, systems)
- Communicate with claimants or their legal representatives as required
- Comply with complex state legislative requirements in terms of claims practices and report any fraudulent activities to the appropriate sources
- Comply with departmental procedures
- Actively participate in claims department projects that improve effectiveness and efficiency
- Other duties as assigned
Yêu cầu
- Post-secondary education or equivalent work experience
- May require LOMA 280, 290 (or obtained within 12 months of hire)
- Detailed knowledge of claim function including the claims, in-force administration systems and imaging/workflow systems
- Sound knowledge of insurance beneficiaries
- General knowledge of referral areas
- Sound organizational, communication and interpersonal skills
- Sound analytical skills; ability to define, research and resolve problems
- Sound knowledge of mainframe and PC environment
- Ability to prioritize and work effectively under deadlines balancing published service times with an appropriate customer focus
- Ability to comprehend, retain and apply current technical information to daily work issues
- Knowledge of insurance contract law and state legislative requirements
- Sound knowledge of company plans, riders and benefits including sound knowledge of insurance contract language
- Basic knowledge of reinsurance process
- Basic knowledge of claim accounting
Hình thức làm việc
- Hybrid
Thông tin khác
- When you join our team: We’ll empower you to learn and grow the career you want. We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. As part of our global team, we’ll support you in shaping the future you want to see. Working Arrangement: Hybrid. Manulife is an Equal Opportunity Employer.