Shanghai, 31, CN


Claims Manager 

About Swiss Re

Swiss Re Corporate Solutions provides risk transfer solutions to large and mid-sized corporations around the world. Its innovative, highly customised products and standard insurance covers help to make businesses more resilient, while its industry-leading claims service provides additional peace of mind. Swiss Re Corporate Solutions serves clients from over 50 offices worldwide and is backed by the financial strength of the Swiss Re Group.


About the Team

Swiss Re Corporate Solutions China is now looking to build business with personal insurance products sold under the brands of existing and new distribution partners. Execution of this strategy is via a B2B2C model across a variety of primary platforms. In this role, you will be responsible for assisting Head of Customer Services in defining personal lines claims policies, processes, procedures and service standards. You will work with and manage vendors to deliver superior claims experience on a day-to-day basis. You have a customer-first mindset and love to handle specific claims cases to control claims risk, reduce claims expenses and exceed customer satisfaction. You will have a great opportunity to study and apply new technologies like mobile and artificial intelligence to improve and automate our claims processes, firstly to respond to customers fast and 24x7, and secondly to drive down our service cost.


About the Role

  • Work with Head of Customer Services in defining claims standards, policies, processes and operational guidelines
  • Handle claims cases, coordinate internal and external resources to resolve requests from customers in the areas of claims
  • Conduct proactive case management of large loss and complex claims with timely notification and approvals as per operating procedures
  • Support the management team to define and manage fraud control measures, frameworks and operations across providers' network
  • Handle pre-certification of out-patient, day-patient and in-patient treatments by coordinating treatment needs with the benefits offered in the insurance plan
  • Generate and analyze claims reports, constantly identify areas to be improved and come up with solutions, then drive through to implementation phase
  • Respond to regulators' request on claims cases, resolve complaints in a professional and compliant manner, and handle potential conflicts with partners and end customers
  • Collaborate with partnership managers to define claims handling procedures, value propositions, processes and contingent plans to maintain strong partnership relationship
  • Author requirements on behalf of claims team, review and negotiate with implementation team to ensure system capabilities and performance meet claims handing needs and budget constraints
  • Manage and coordinate with Third Party Administrators (TPAs) to maintain and improve claims service network continuously


About You

  • You are very passionate about claims and love to handle repetitive and unique customer requests
  • You like technologies, mobile applications, and artificial intelligence etc., and dare to try new things to claims services
  • You pay attention to details and feel compassionate about partners and customers
  • You have curiosity, intellectual capabilities and perseverance to continuously improvement your processes and aim to building a first-class claims system
  • You are patient in handling external stakeholders such as regulators, TPAs and partners
  • You can work under time constraints and pressure, and are excellent at handling conflicts and complaints from various stakeholders
  • You are a great team player and love to identify claims solutions together with partnership managers and other cross functional teams
  • You are influencing and can communicate your ideas to all key stakeholders clearly


  • College degree or higher in insurance, business, medical and operations etc.
  • MBA degree is a plus


  • Excellent written and oral communication skills in Chinese Mandarin is a prerequisite, and
  • Fluency in English is a must

Professional experience

  • 5 years of relevant experience in P&C and/or Life/Health insurance claims, call centres and operations
  • Experience in defining claims policies, processes and procedures etc., and have skills in handling large and complex claims cases
  • Familiarity with insurance company end to end operations and experience in handling customers' complaints in the claims area
  • Demonstrated experience in managing multi-line insurance claims such as travel, accident, medical, critical illness and other P&C personal product lines
  • In-depth understanding of local P&C market, frequent issues, compliance, and regulatory requirements on claims
  • Demonstrated innovative experience and successful cases in applying new technologies to drive customer satisfaction and operational excellence through automation in claims area
  • Experience in vendor management, contract management, and records management
  • Understanding of digital marketing, mobile technologies, big data and artificial intelligence, and its application in customer satisfaction, anti-fraud and efficiency improvement

Other skills required

  • MS Office Suite: MS Word, PPT, EXCEL
  • Outstanding interpersonal, communications and presentation skills


Reference Code: 87944