Senior Claims Operations Specialist
Do meaningful work with us. Every day.At Amplify Health, we’re looking for individuals with ambition, resilience and passion for healthcare, insurance, wellness and digital technology. As a fast-growing business with the ambition of making people and communities across Asia healthier, we have exciting career opportunities available to help us achieve our vision.Based in Hong Kong and reporting to the Claims Operations Lead, the Claims Operations Specialist is responsible for implementing Amplify Health’s in‑market strategy for claims operations solutions. The role serves as a critical interface between client relationships, external stakeholders, including providers and regulators, and internal stakeholders to align transformation efforts with industry standards and requirements. Key to success in this role will be the ability act the key conduit between the numerous business stakeholders and technical teams to translate complex business needs into actionable operational, process, and technology solutions for clients. As Claims Operations Specialist, Hong Kong, at Amplify Health you will play a key role in shaping the future of Hong Kong’s claims management process. You will be working with some of the largest healthcare payors in the country, as well as providers and regulators to leave a lasting impact on the industry.Responsibilities Strategy Development & Execution Partner with the Claims Operations Lead to develop and implement an in‑market strategy that drives end‑to‑end transformation of claims operations and claims risk management. Identify opportunities to enhance operational efficiency through organisational redesign, process optimisation, automation, and technology adoption. Drive initiatives to increase straight-through processing (STP), reduce manual effort, and enhance adjudication accuracy. Track key KPIs to measure value realisation and operational effectiveness. Technology and Innovation: Collaborate with AH’s product teams to design and deploy AH solutions. Collaborate with the client’s technology/data teams to ensure deployment of technology/data solutions are aligned with operational needs and changes to optimize the value in delivery. Work closely with technology teams to deploy AI-driven solutions for fraud detection, waste minimization, and claims adjudication. Oversee the integration of advanced analytics tools and predictive models to streamline claims workflows. Evaluate emerging technologies and partner with insurtech vendors to stay at the forefront of industry innovation. Process Optimisation Lead transformation of end‑to‑end claims processes with a focus on cost and operational efficiency. Implement best‑practice frameworks for quality assurance, compliance, and medical claims management. Develop, monitor, and continuously refine KPIs to suppo...