Process Executive - Claims Excellence (Cantonese Speaker)

Job Responsibilities and Expectations :

• Assist in validating and processing health insurance claims in accordance with Insurance Authority (IA) guidelines.
• Ensure accurate data entry and documentation of claim details in the claims management system.
• Support the review of claims for completeness and compliance with policy terms and conditions.
• Coordinate with internal departments to gather missing documentation or information.
• Flag potential discrepancies or anomalies for further review.
• Maintain confidentiality and data protection standards in handling sensitive health information.
• Respond to basic inquiries from policyholders regarding claim status and documentation requirements.
• Ensure timely processing of claims to meet service level agreements (SLAs).
• Assist in generating reports for internal tracking and audit purposes.
• Stay updated on changes in claims procedures and regulatory requirements in Hong Kong.
• Support continuous improvement initiatives in claims processing workflows.
• Participate in training sessions related to claims systems and regulatory updates.
• 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 status of a claim – and what information may be needed, next steps in processing, etc.

Academic and Additional Qualifications Needed :

About Cognizant :

Cognizant (Nasdaq : CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant.

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