Shanghai, CN
1 day ago
高级专员,大健康医学审核

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Sound like you? Then read on.

About the Role

医学审核预授权案件,做好前端的控费,保证产品理赔率的良性发展;
辅助公司内各个项目的医学支持和审核;
针对服务和产品进行医学创新支持等。

工作职责:

1、    负责处理日常高端医疗预授权案件,保证服务品质和时效;
2、    根据国家相关法律和保险条款规定,保障客户权益,从预授权前端控制产品理赔金额,防止医疗滥用,保证产品理赔率的良性发展;
3、    为客户和其他相关部门提供医学咨询,及时与医院/服务供应商/客户沟通,进行合理合规恰当干预;
4、    复杂案件评估,必要时提供长期医学协助;
5、    根据医学热点或者新技术进行医学科普(推文/讲课/视频录制等);
6、    对现有健康管理服务提出医学创新建议;
7、    辅助网络部反馈医疗滥用医院,协助网络管控;
8、    及时保质保量完成领导安排的其他工作内容。

任职资格:

1、    临床医学专业,本科以上学历;
2、    三年以上临床工作经验,三甲医院优先;
3、    善于沟通,流利英文;
4、    具备较强团队合作精神和客户服务的意识;
5、    熟练使用办公软件如Word, Excel, MS Outlook. PowerPoint等。
6、    具备保险公司相同工作经验者优先。

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

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