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.
ROLE PURPOSE:• Provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management.
ROLE DUTIES & RESPONSIBILITIES:
This role is accountable and responsible for the following:
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Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level.
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Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.
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Manage claims investigation by working with claimants, financial consultants, medical institutions, insurers, etc to determine claims decision and payment.
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Follow up on outstanding requirements needed for claims adjudication through documented follow-up process and provide regular update on claims status.
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Work closely with other business units to ensure that claims are processed accurately and that all service level agreements are met.
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Manage enquiries and appeals arising from claims.
KEY PERFORMANCE INDICATORS:
Improving the customer's Instant experiences on claims by:
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Ensuring that the claims are processed within the expected service level;
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Attaining the benchmarked targets for productivity, claims pending rate, suspense management rate
Additional Job Description
Competencies & Personal Traits
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Excellent communication, interpersonal and problem-solving skills with ability to investigate, evaluate and reach an appropriate decision
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Customer-centric with ability to work under pressure
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Self-motivated and able to work independently
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Team player, mature, with excellent leadership quality.
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Good medical knowledge and claims settlement procedure.
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Ability to read basic Chinese will be advantageous
Working Experience
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At least 1-2 years of experience as a Life & Health claims assessor
Language
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Strong command of English language
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Basic Chinese will be advantageous
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
- At least 1-2 years of experience as a Life & Health claims assessor
- Excellent communication and interpersonal skills
- Customer-centric and able to work under pressure
- Good medical knowledge and claims settlement procedures
- Ability to read basic Chinese will be advantageous
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
