Executive, Claims-3

Posted 6 Hours Ago
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Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, MYS
In-Office
Junior
Financial Services
The Role
The role involves managing and adjudicating claims for group insurance services, ensuring compliance, and providing efficient claims management support.
Summary Generated by Built In

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

In this role, you will provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management.

·     Adjudicate Group Major Claims (Death, TPD, Critical Illness, Disability, Terminal Illness, etc) and Group Medical Claims (Hospital & Surgical, Major Medical, Outpatient Specialist, Outpatient Clinical, Dental, etc) and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time).

·     Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.

·     Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.

·     Manage working relation with external parties – Central Provident Fund Board (CPFB), medical institutions, TPAs, etc.

·     Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment.

·     Manage enquiries, service recovery, complaints and appeal arising from claims.

·     Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.

·     Any other ad-hoc assignment assigned.


Who we are looking for:

Competencies & Personal Traits


·     Detail-oriented with a commitment to accuracy and quality.

·     Innovative and resilient with a strong eye for detail

·     Excellent communication skills in English, both written and verbal

·     Conflict resolution and relationship management skills

·     Customer-centric with ability to work under pressure

·     Self-motivated and independent

·     Team player


Working Experience

·     2 to 3 years of working experience in both life and medical claims processing

Education

·       Diploma or Degree


Language

·       English


 

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

Skills Required

  • 2 to 3 years of working experience in life and medical claims processing
  • Diploma or Degree
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The Company
HQ: Central, Hong Kong
52,292 Employees

What We Do

In Asia and Africa, Prudential has been providing familiar, trusted financial security to people for 100 years. Today, headquartered in Hong Kong and London, we are ranked top three in 12 Asian markets with 18 million customers, around 68,000 average monthly active agents and access to over 27,000 bank branches in the region. Prudential is focused on opportunities in the most exciting growth markets in Asia and Africa. With access to over 4 billion people in both these regions, we are investing in broadening our presence and building our leadership in the life and asset management markets. We are committed to making a positive impact on our customers, our employees and our communities by delivering the best savings, health and protection solutions to people so they can get the most out of life. Visit our websites for more information Prudential plc: https://www.prudentialplc.com/ Prudence Foundation: https://www.prudentialplc.com/en/prudence-foundation

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