Claims, Consultant

FIND YOUR 'BETTER' AT AIA We don't simply believe in being 'The Best'. We believe in better - because there's no limit to how far 'better' can take us. We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives. If you believe in better, we'd love to hear from you.

About the Role

Claims Operations Management • Support the Claims Team Head in leading and managing Corporate Solutions Claims operations to ensure efficient, accurate, compliant, and customer centric claims handling, aligned with AIA's purpose of helping people live Healthier, Longer, Better Lives. • Oversee daily claims operations across Hong Kong based post sales servicing and Transaction Hub (TxH) operational support to ensure consistent service delivery and governance standards. • Monitor team performance against agreed service standards, including turnaround time, quality, accuracy, and customer satisfaction, and proactively identify performance gaps or opportunities for improvement. • Assist in workload planning, prioritization, and issue escalation to ensure service commitments are consistently met across all operating locations. • Support continuous improvement initiatives to enhance service quality, operational efficiency, and end to end customer experience People Development, Coaching & Performance Support • Provide on the job coaching, guidance, and mentoring to Claims Team members to enhance claims handling effectiveness, decision quality, and customer service capability. • Foster a strong customer centric mindset within the Claims team, reinforcing behaviours that balance policy, compliance, and fair customer outcomes. • Assist in identifying training needs and support the design and delivery of learning initiatives covering claims processes, governance requirements, and customer service skills. • Support the development of a capable, engaged, and high performing team aligned with service standards and operational objectives.

Roles and Responsibilities:

• Claims Operations Management & Service Delivery (25%) Oversee end to end assessment of complex Group Medical and Group Life claims, ensuring accurate, fair, and timely claim outcomes in accordance with policy terms and service standards. Lead and support post sales servicing activities, including reconciliation, ASO handling, audit preparation, complaint management, and implementation of tailored client servicing arrangements. Monitor operational performance and service delivery across Hong Kong based post sales servicing and TxH operational support to ensure consistency, efficiency, and service commitments are met. Analyse claims trends, operational data, and performance insights to identify root causes, mitigate risks, and recommend process or service improvements. Collaborate closely with Transaction Hub (TxH), Network Providers, Finance, Contact Centre, and other internal partners to ensure seamless claims operations and end to end service delivery.
• Technical Claims Oversight & Decision Support (5%) Review, process, and approve claims within delegated authority, including complex or high‑value claims and cases exceeding TxH authority limits. Provide technical advice and escalation support to Claims Team members on claims assessment, adjudication, and policy interpretation. Perform quality reviews across claims handling activities to ensure adherence to established claims practices, guidelines, and regulatory requirements.
• Customer & Stakeholder Management (Customer Centric Focus) (25%) Uphold AIA's Customer First principles by delivering clear communication, responsive service, and proactive case management for key corporate clients, intermediaries, and members. Support key client meetings, service reviews, corporate tender responses, and internal governance forums by providing claims expertise, service insights, and operational input. Partner with internal and external stakeholders to enhance customer experience and strengthen confidence in claims service delivery.
• Governance, Quality Assurance & Compliance (20%) Drive operational excellence through strong governance, quality control, and adherence to regulatory, audit, and internal compliance requirements. Ensure consistent application of claims policies, authority limits, documentation standards, and data privacy controls. Support audit engagements and regulatory reviews by ensuring readiness, accuracy, and timely remediation of findings.
• Projects & Business Process Re-engineering (BPR) Initiatives (20%) Act as a Subject Matter Expert (SME) for Corporate Solutions claims in business initiatives, system enhancements, policy changes, and process transformation projects. Contribute to project activities including requirements definition, process design, documentation, testing, implementation, and post‑delivery review. Coordinate with cross‑functional stakeholders to ensure project milestones, deliverables, and timelines are achieved.
• Other responsibilities (5%) Perform additional duties as assigned by management to support operational, regulatory, or business needs. Support management initiatives aimed at improving claims capability, service excellence, and operational resilience.

Requirements:

• Solid experience in Group Medical and/or Group Life claims, with a strong understanding of Hong Kong market practices, products, and post sales servicing requirements.
• Proven leadership capability, with experience guiding and supporting a claims team managing high service expectations and complex corporate client portfolios.
• Strong knowledge of regulatory requirements, internal compliance standards, audit expectations, and enterprise risk management as they relate to claims operations.
• Demonstrated customer centric mindset, with the ability to balance service excellence, fair customer outcomes, risk control, and operational efficiency.
• Strong analytical and problem-solving skills, with the ability to interpret claims data, identify trends or root causes, and recommend practical improvement solutions.
• Excellent communication and stakeholder management skills, including the ability to manage sensitive, complex, or escalated cases with professionalism and sound judgment.
• Collaborative, adaptable, and proactive in driving continuous improvement, with behaviours aligned to AIA's "How We Work" principles.
• Able to operate effectively in a dynamic environment involving multiple stakeholders, cross border operations, and evolving business or regulatory requirements.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives. You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date. 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. As the largest listed company on the Hong Kong Stock Exchange, we've been proudly making a difference for people and communities across Asia for over a century. And we build on this every day with our ambition to engage one billion people to live Healthier, Longer, Better Lives by 2030. If you work at AIA, you play an important part in this movement. Which is why we give you every opportunity to learn, grow and shape your career - your way. Inspiring and supporting you to thrive - not just at work, but in life. Believe in better with AIA. View our AIA LinkedIn page Bring your difference to AIA