Senior Operations Executive

Operations / Senior Operations Executive (Claims) Health Tech Platform

Key Responsibilities

• Manage and oversee a portfolio of complex claims, ensuring prompt, accurate, and transparent processing in accordance with internal SLAs and regulatory standards.
• Provide guidance, training, and support to claims and customer service team members; act as a Subject Matter Expert (SME) to resolve escalated cases and develop best practices.
• Investigate, assess, and adjudicate claims, including review of documentation, data analytics, and digital health records, to determine eligibility, coverage, and liability.
• Ensure strict compliance with company policies, industry regulations, and evolving digital health legislation in local and international markets.
• Monitor, analyze, and report on claims performance using KPIs and dashboards; drive data-driven process improvement projects aiming for higher efficiency, automation, accuracy, and customer satisfaction.
• Collaborate cross-functionally on system enhancements as well as solving customer enquiries.
• Maintain accurate up-to-date claims databases and generate regular and ad hoc management reports for internal and regulatory review.
• Proactively identify operational risks and recommend process or technology improvements.
• Process Business as Usual (BAU) operational processes as well and any ad hoc tasks to improve company efficiency.

Qualifications

• Bachelors degree in business, finance, insurance, health administration, or a related field.
• Minimum 2-3 years experience in claims management, ideally in life/health insurance or a digital health platform in Asia.
• Preferred Experience with claims operating systems, workflow automation, and data analytics tools; proficiency in Microsoft Office and relevant claims management software.
• Sound knowledge of insurance regulations, industry standards, and digital health compliance requirements in Asia.
• Strong analytical, investigative, and problem-solving skills with a keen eye for process optimization.
• Excellent communication, negotiation, and interpersonal skills; able to engage diverse stakeholders and influence outcomes.
• Self-driven, results-oriented, and comfortable working in fast-growing, dynamic, and digital-first environments.
• Strong language capabilities especially in Cantonese, Mandarin as well as English