HSBC Group

Open positions:1

Global Career Band: 8

Why join us?

The role holder is accountable to ensure the Insurance business service targets exceed business partner and customer expectations, and is responsible for Insurance Business Service oversight, assessment, continuous improvement and quality reviews. Also, the role holder will ensure employee benefits service expectations are defined, measured and assessed, business impact of service problems is communicated, understood and actions progressed to prevent re-occurrence, as well as provide Insurance business insight to, and ensure appropriate communication of, Insurance business change activities or concerns.

The Opportunity:

• Maintain strong relationships and liaise with Insurance business functions to ensure the customer expectations are understood, measured against and being met and/or exceeded.
• Ensure appropriate communication of business / regulatory requirement, business impact, cost-and-benefit analysis, major problems and change.
• Communicate status, identifying risks and issues for resolution and remediation.
• Articulate and report to the business partners / stakeholders in timely fashion if any risks/issues are raised.

What you’ll do:

• Managing third parties (i.e. TPA) to operate in conformance with HSBC standards and regulatory requirements.
• Maintaining high quality Insurance service provision with reduced unplanned business impact in an environment of large business volume of medical claims, enhanced regulatory oversight and stringent cost management.
• Working with business lines and functions to understand and ensure transparency in quality performance from a customer perspective, in the language of the business and clearly articulating the business impact and cost of service problems.
• Ensuring effective management of issue handling to enable root cause analysis for remedial actions, preventive measures and timely management reporting.

What you will need to succeed in the role:

• Assist to develop and implement claims policy, guidelines and standards. Regular review the administration procedures to ensure all activities are processed in the most effective means.
• Support implementation of Health Ecosystem automation.
• Assess and approve claims within own claims authority and make recommendation to senior for those claims exceeding own authority limit, conduct claims investigations where necessary.
• Assist in overseeing the operations of claims and case management. Resolve day to day claims related issue for all EB products.
• Identify ineffective claims practice. Report and assist in driving initiatives for change.
• Provide assistance in conducting routine audits to assure quality and timely processing targets are maintained and corrective action is taken to avoid recurrence.
• Support in monitoring trends in claims and prepare necessary statistical information and regular reports for management use.
• Assist in service providers monitoring and control.
• Ensure business objectives are delivered in accordance with procedures and service standard and the business operated in accordance with Group and regulatory compliance and with robust internal control.  Deliver timely response and provide viable solutions to clients to meet customer expectations.
• Follow the internal HSBC protocol and external regulatory requirement to support the Third Party Administration agreement with service supplier from health insurance perspective.
• Collect market intelligence and feedback to facilitate services competitiveness improvement. Stay abreast of medical advance technology or information for claims adjudication.

What additional skills will be good to have?

• 5 years or more solid working experience in claims adjudication and medical services pre-approval in life or medical insurance.
• Knowledge on Employee benefits products (e.g. group life) and back office operations.
• Proven and progressive experience preferably incorporting business operations management principles (including service quality, business control and continuous improvement activities etc.).
• Excellent understanding of quality assurance, control, metrics and continuous improvement.
• Strong analytical skills to understand to translate, simplify and proritize the requirement as well as root cause analysis for remedial actions / preventive measures.
• Strong communication and interpersonal skills required, including the ability to form effective relationships and achieve influence at the most senior level in the organisation.
• Understand and interpret complex business and Hong Kong Insurance requirements (including regulatory requirements).
• Ability to work within an environment of different cultures.

Please refer the Candidate User Guide in the below link to understand your own journey as a candidate.

https://hsbchrdirect.service-now.com/esc?id=kb_article&table=kb_knowledge&sysparm_article=KB0184596&sys_kb_id=712b5f041b1f82908d3a0fe7ec4bcbd6

You’ll achieve more at HSBC

HSBC is an equal opportunity employer committed to building a culture where all employees are valued, respected and opinions count. We take pride in providing a workplace that fosters continuous professional development, flexible working and, opportunities to grow within an inclusive and diverse environment. We encourage applications from all suitably qualified persons irrespective of, but not limited to, their gender or genetic information, sexual orientation, ethnicity, religion, social status, medical care leave requirements, political affiliation, people with disabilities, color, national origin, veteran status, etc., We consider all applications based on merit and suitability to the role.

Personal data held by the Bank relating to employment applications will be used in accordance with our Privacy Statement, which is available on our website. 

***Issued by HSBC Electronic Data Processing (Guangdong) Ltd. GSC China***

(* The information contained in this job description is a true and accurate reflection of the job as specified.)