Medical Case Manager- Health Insurance Co

by Varsha Mankani in Insurance/Pension funding    30th Nov, 2020       Hong Kong, Hong Kong, Hong Kong SAR

Medical Case Manager- Health Insurance Co

Introduction:

Our client is a highly well established and respectable medical insurance company. We are now seeking a Case Manager (Medical) who will be responsible for the following:

Responsibilities:

  • Handle the entire process of individual case management and an independent manner.
  • Manage the financial and cost aspects in accordance with the company’s guidelines such as by identifying opportunities to reduce claim expenses.
  • Handle enquiries from members, providers, partners regarding coverage plans, claims issues, alternative treatments etc
  • Coordinate with clinical staff to assess conditions and treatments.
  • Prepare case reports for investigations conducted.
  • Negotiate medical costs
  • Participate in ad-hoc tasks as and when assigned.

Requirements:

  • Degree in Nursing highly preferred
  • Strong medical background with a good understanding of medical treatments, medical insurance etc.
  • Knowledge of clinical billing and coding is a must – Certified coding degree is a plus.
  • Strong language and communication skills in English and Chinese.
  • Good in negotiation, presentation and reporting.

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