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Job Title :
Medical Claims Adjudicator (HK GLH Claims)
Job ID :
Category :
Location :
PHQC-Manulife Building, Quezon City PH
Job Type :
Full Time
Posted On :
Job Description :

Are you looking for unlimited opportunities to develop and succeed? With work that challenges and makes a difference, within a flexible and supportive environment, we can help our customers achieve their dreams and aspirations.

Job Summary

The Medical Claims Team is responsible for assessing and processing Chinese and English medical claims within pre-set service turn-around-time with quality standards. The job purpose is to ensure that the processors are able to meet individual and team goals in line with the Service Level Agreement (SLA).

Key Accountabilities:

The Medical Claims Processor’s key responsibilities for this position are:
  • Handles outpatient / inpatient claims mainly from Hong Kong, Macau and Mainland China
  • Issues follow-up letters to the clients for outstanding information and clarifications
  • Process cases with high accuracy and productivity standards
  • Practice good judgment in approving and declining medical claims of clients
  • Take additional training program provided in increasing medical knowledge
  • Help out other associates during absence
  • Suggest ways on how to improve the current process and team metrics
  • Consistently attain the service level set by the Company
  • Constantly increase the number of knowledgeable functions handled by the team
  • Such other duties and functions as assigned by Operations Management

Job Requirements (Knowledge/Skills/Competencies):
  • Bachelor’s Degree/Master’s Degree in related field
  • With high Chinese proficiency and preferably knowledgeable in Chinese medical terminology
  • Good computer skills and with fast and accurate typing
  • Adherence to quality service
  • Good organization and analytical skills
  • Ability to express ideas clearly and concisely in writing
  • Careful and attentive to detail even when under time-constraints
  • Team-oriented yet able to work independently
  • Willing to render overtime work as needed
  • Flexible and adaptable to change
  • Proven ability to balance approach in different levels of transactions
  • Effective communication and problem solving skills
  • Willingness to experiment and take risks
  • Can handle multiple tasks in a fast-paced environment
  • With medical background/experience in insurance firm is an advantage
Technical Competency
  • Proficient in handling all the work and processes assigned
  • Consistently meets and exceeds job requirements
Behavioral Competency
  • Always on time to work and to meetings and is not sickly
  • Willingly jumps into the work stream during volume peaks or to cover up for absent staff
  • Dependable and does everything possible to meet targets and team commitments
  • Tends to be active and participative in team meetings, shares good ideas
  • Accountable for one's actions
  • Compliance-minded
  • Demonstrates initiative to improve
  • Extra-miler and constantly pushes the limits of current responsibilities
  • Has a positive attitude towards accepting additional challenges and new assignments
  • Customer-centric and service oriented
  • Independent and has a bias to action
  • Actively pursues personal and professional development opportunities
  • Always sets good example and can be relied upon in any situation
  • Willfully gives his/her personal time to participate in company activities such as charity events, sportsfest, etc.
About Manulife

Manulife Financial Corporation is a leading international financial services group that helps people achieve their dreams and aspirations by putting customers' needs first and providing the right advice and solutions. We operate as John Hancock in the United States and Manulife elsewhere. We provide financial advice, insurance, as well as wealth and asset management solutions for individuals, groups and institutions. At the end of 2016, we had approximately 35,000 employees, 70,000 agents, and thousands of distribution partners, serving more than 22 million customers. At the end of 2016, we had $977 billion (US$728 billion) in assets under management and administration, and in the previous 12 months we made almost $26 billion in payments to our customers. 

Our principal operations are in Asia, Canada and the United States where we have served customers for more than 100 years. With our global headquarters in Toronto, Canada, we trade as 'MFC' on the Toronto, New York, and the Philippine stock exchanges and under '945' in Hong Kong.

Manulife is committed to supporting a culture of diversity and accessibility across the organization.   It is our priority to remove barriers to provide equal access to employment.  A Human Resources representative will consult with applicants contacted to participate at any stage of the recruitment process who request an accommodation. Information received regarding the accommodation needs of applicants will be addressed confidentially.
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