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Case Management Specialist/Senior Underwriting Specialist/Senior Policy Services SpecialistMotiva Consulting Limited
Case Management Specialist/Senior Underwriting Specialist/Senior Policy Services SpecialistMotiva Consulting Limited

Job Highlights

  • Underwriting
  • Policy Services Specialist
  • Case Management Specialist

Job Description

Our client is the leading Insurance Company in Hong Kong and its provide life insurance, general insurance, pension to the customers, due to the business expansion, they are looking for high caliber to join their Risk and Compliance team.

Position 1:

Case Management Specialist

Key Role and Responsibilities:

  • 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
  • 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

Qualifications and Skills:

  • 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

Position 2:

Senior Underwriting Specialist

Key Role and Responsibilities:

  • Assesses and approves new business application upon underwriting authority within agreed turnaround time in order to meet department benchmark and accuracy based on productivity report, reissue report, management report and audit result.
  • Handles email & telephone enquiries from internal and other departments like Premium collection, Operations Service Centres, MCV business and Agency Business Development Department etc and handle appeal / special cases with fair and flexible approach within agreed stipulated timeframe.
  • Conduct training to internal staff and agency force, also new comers etc in order to support the development and enhance the competency levels and performance.
  • Handles department projects, system enhancement, system reporting and other ad-hoc tasks as assigned within timelines.
  • Provide constructive input in streamlining workflow and liaises with IT and OBS for system enhancement.

Qualifications and Skills:

  • University/Collage graduate with 3 - 4 years’ experience OR
  • Form 5 graduate plus 6 - 8 years related experience
  • Problem – solving and communications skills
  • Good communication skills in Cantonese and Mandarin

Position 3:

Senior Policy Services Specialist / Assistant Manager, Policy Services

Key Role and Responsibilities:

  • Monitors & controls the productivity, quality & efficiency of the team by reviewing the productivity report, reissue, audits and management reports in order to ensure consistency and accuracy of the output.
  • Participates in company strategic projects.
  • Organizes and provides POS training to internal staff, OSS and agencies.
  • Handles internal enquiries and special handling of FYC adjustments.
  • Underwrites, approves cases which exceed subordinates’ authority.
  • Handles requests received from DD meeting and agency leaders’ telephone enquiries.
  • Conducts periodic audits to ensure the POS transactions of Operations POS, PRC Business and OSS are properly performed.
  • Reviews POS procedures and internal/external guideline are standardized and updated.

Qualifications and Skills:

  • University /College graduate plus 5 years relevant experience with 2 years supervisory experience OR
  • Form 5 graduate plus 8-10 years related experience
  • Effective problem solving and communication skills

Additional Information

Career Level

Not Specified


Not Specified

Years of Experience

Not Specified

Employment Type

Full Time

Additional Company Information

Benefits & Others

Five-day work week, Free shuttle bus, Medical insurance