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.
