Lam Chin Fung Timothy
Kowloon
Summary
Seeking a challenging opportunity where I will be able to utilize my strong organization skills, education backgrounds, and ability to work well with people and professionally.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Customer Service Officer
Cigna Worldwide Life Insurance Co Ltd
Hong Kong
01.2024 - Current
- Support email and hotline on global group policy queries
- Verify policy coverage and eligibility for medical services via email and call, ensuring all the necessary information is obtained and documented.
- Handle preauthorization requests from customers and healthcare providers with follow-up on progress and good record keeping.
- Collaborate with internal teams, such as billing and claims to facilitate payment processes.
- Stay updated on insurance plans, policies, and procedures to provide accurate information and guidance to customers.
- Handle escalated customer issues and complaints, demonstrating empathy, problem-solving skills, and a commitment to customer satisfaction.
- Provide administrative support including reports and correspondences.
- Assist in the UAT on development of customer Portal and customer service project.
Claims Specialist
Blue Cross
07.2023 - 12.2023
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Assess, handle and approve all claims types and authorize claims payment based on delegated authority and refer claims beyond authority to Head of Claims together with sound recommendations.
Claim Specialist
Allianz Global Corporate & Specialty SE
02.2022 - 07.2023
Claim Specialist
Allianz Global Corporate & Specialty SE
02.2020 - 12.2021
- Adjudicate different types of claims of general insurance (Medical / Life / Accident / Hospital Income / Home / Fire/Motor/Travel)
- Validate claims settlement and cheque requisitions within limit of authority
- Handle phone calls /email of claim and customer enquire and complaint
- Prioritize work effectively and according to team's Service Level Agreement
- Monitoring TPA service
- Assist in UAT and ad hoc project
Claim Specialist
Aetna International Insurance
06.2019 - 09.2019
- Process/approve claim payments utilizing claims process
- Liaise with clients via phone, email or fax to obtain specific approval or authorization for prearrangement and to determine accurate and valid coverage information. Interpret and apply insurance benefits
- Provide administration support in claims area such as compose claims correspondences, set up, review and revise claims procedure or guidelines or workflows and claims forms
- Analyze, provide advice and handling strategy for complaint/appeal claim cases
- Involve in approving claims cases within own claims authority; make recommendation to senior for those claims exceeding own authority limits
- Producing reports from the system and assisting with preparation of the claims report as required
- Attending to broker, agent, provider and client enquiries on claims and attend to follow ups
Claims Officer
Prudential Hong Kong Limited
11.2016 - 03.2019
- Ensure turnaround time of appeal claim cases is met
- Handle enquiries and complaints from customers, internal staff and media including but not limited to Insurance Authority , Independent Complaint Bureau
- Assessment of Inpatient/Outpatient/Accident/Death/ Critical illness claims in accordance with policy contract and guidelines
- Investigate and escalate technical claim
- Communicate with claims committee and re-insure company when handling rescind cases
- Obtain professional opinion from In-house doctor and underwriter
- Provide technically correct claims management decisions within authority while applying appropriate balance of service and risk management
- Build successful relationship with agents
Customer Service Officer
Assistance Alliance International (HK) Limited
11.2015 - 11.2016
- Handle enquirers from clients and insurers
- Provide and process information in response to their feed, concerns and requests about insurance products and services
- Communicate and coordinate with relevant parties to obtain and evaluate all relevant information
- Ensure efficiency and effectiveness of daily operations for insurance policy administration
- Perform other ad-hoc duties
- Well knowledge about claim procedure
- Fully understand claim status and explain to agent/client
- Handle pre-authorization claims ( study case and inform agent about result whether approved or not )
Education
Diploma of Financial Services
09.2023
Bachelor of Business Administration - Business Administration
Queen's University of Brighton (U.S)
U.S09.2009
Skills
Great Mathematical Skills
Product Selection
Policy Modification
Microsoft Office
Certification
- ANZIIF (Senior Associate CIP Member) = IIQE paper 1, 2, 3 & 6.
- ALMI (Associate, Life Management Institute)
Expected Salary
$32,000 - Negotiable.
Timeline
Customer Service Officer
Cigna Worldwide Life Insurance Co Ltd
01.2024 - Current
Claims Specialist
Blue Cross
07.2023 - 12.2023
Claim Specialist
Allianz Global Corporate & Specialty SE
02.2022 - 07.2023
Claim Specialist
Allianz Global Corporate & Specialty SE
02.2020 - 12.2021
Claim Specialist
Aetna International Insurance
06.2019 - 09.2019
Claims Officer
Prudential Hong Kong Limited
11.2016 - 03.2019
Customer Service Officer
Assistance Alliance International (HK) Limited
11.2015 - 11.2016
Diploma of Financial Services
Bachelor of Business Administration - Business Administration
Queen's University of Brighton (U.S)
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