Leading and mentoring the Medical Claims team, setting performance goals, and monitoring KPIs. Review and assess medical claims , ensuring alignment with policy guidelines and service standards. Review and process complex claims cases and handle the case escalated by team members Prepare and analyses the claims data and reports Collaborate with HK Claims Team to conduct assessment and investigation if needed. Provide guidance and support to facilitate junior advisors in service delivery and daily operations Drive continuous improvement initiatives to optimize claims processing workflows Providing the trend of suspicious case to suggest a FWA dedection framework Updating the SOP and training note Preform daily QC to ensure the team's accuracy