Job ref no.: 107236861-35063 (CT3121488-01#0125)
AIA Hong Kong and Macau

Case Management Specialist, Healthcare Management

AIA Hong Kong and Macau

  • 5-day week
  • Medical plan
  • Shuttle bus

Job Summary

Contribute to the team by providing case management service at our medical network, process pre-approval request and handle enquiries from customers, agents and service providers.

Roles and Responsibilities

On-site Case Management Support at network providers

  • Handle customers and agents enquiries and complaints regarding all activities in medical insurance policy operation process including Pre-approval, Letter of Guaranteed (LOG), Medical Service booking and advice, Claims and In/Outpatient arrangement

  • Follow up on survey result identify area of improvement and action taken to maintain customer satisfaction

Pre-approval and Case management service

  • Process pre-approval requests in accordance with the terms and conditions of the policy and the authority level with the benchmark of 2 working days turnaround time

  • Check eligibility of the member for benefit entitlement

  • Issue Letter of Guarantee whenever required

  • Approve Pre-approval with agreed fee and negotiates with the service providers’ to follow the logic of agreed fee and under the technical direction of Medical Officer

  • Handle Non-Network pre-approval duties whenever required

  • Coordinate with Hotline service team to ensure smooth operation

Service Enhancement initiatives projects

  • Review existing end-to-end Pre-approval customer journey and streamline as necessary in order to ensure consistency, accuracy of the service delivery and excellent customer experience

  • Review system for enhancement for efficiency and convenience for customers

  • Participate in companywide strategic project (e.g. AIA Connect - Enable status tracking service)

Other duties and responsibilities

  • Participate in projects relating to service enhancement or new business initiatives arise

  • Other duties and responsibilities as assigned by supervisor

Job Requirements

  • University/College graduate in Nursing / Health Administration or relevant disciplines

  • Registered nurse is preferred

  • Knowledge of current care delivery system

  • 2-3 years’ practical clinical & specialty experience

  • Computer literacy

  • Strong interpersonal, communication and analytical skills

  • Good team player and customer focused

  • Self-motivated, willing to take on challenges and able to work under pressure

We offer an attractive remuneration package to the successful candidate.Please submit your application by clicking “Apply Now” for our processing.

All personal information provided by applicant will be treated in strict confidence and used solely for recruitment purposes.The personal information will be used strictly in accordance with AIA’s personal data policies, a copy of which will be provided upon request.It is possible that information about the applicant or the applicant’s application will be shared with AIA and its related companies.AIA will retain all applications for a period of up to 24 months after which the documents will be destroyed.

More job information
Job ref no. 107236861-35063 (CT3121488-01#0125)
Job Function
  • San Po Kong
Employment Term
  • Permanent
  • Full-time
  • 2 years - 5 years
Career Level
  • Entry level
  • Degree