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This job is Assistant Manager, Customer Promise - Healthcare Claims at Prudential. You might like this job because it involves assessing and approving healthcare claims while ensuring compliance with policies and procedures.
Undisclosed
Full-Time
1 week ago
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.
PRINCIPAL DUTIES & RESPONSIBILITIES:
• Adhering to our claim workflow in relation to hospitalization claims procedure.
• Assess and provide justifiable claims according to policy terms and conditions to our valued policy holders.
• Approving claims within the department benchmark/turnaround time and authority limit
• Recommend for claim approval/repudiation
• Ensuring customers enquiry from all sources of referrals are promptly attended to and resolves via appropriate communication mode.
• To ensure and monitor claims processing benchmark and turnaround time
• To correspondences on and day to day operation functions of the department and coordinates with other departments
• To handle incoming enquiries from internal or external parties via emails, phone calls and portal.
• Updating and submission of reports as required by management within the agreed service standards.
• Liaise with Prudential Malaysia’s IT division to troubleshoot issues / cases encountered in the day-to-day operations.
• Continuously review and update/document the administrative rules and processes for effective and efficient operation of the section.
• Continuously attend / involve with training for personal and career development. • Undertake projects / other work and duties allocated by Management, as and when required
• Ensuring that Financial Services Act (FSA), Bank Negara Malaysia, Anti-Money Laundering & Counter-Financing of Terrorism (AML/CFT) efforts, LIAM guidelines and internal guidelines are strictly complied with as applicable.
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.
Our teams are innovative, hands-on and collaborative. The power to share and collaborate requires respect, integrity and teamwork.
Our company is rooted in a rich heritage but to look to the future, we need new energy and perspectives.
We are here to help our employees expand their skills and expertise in various areas.
Last active - few hours ago
0 - 10 Years of Experience
Prudential Assurance Malaysia Berhad (PAMB) is a leading and innovative insurance company in Malaysia, serving the savings, protection and investment needs of Malaysians by offering a full range of financial solutions through its branches, agency force and bancassurance distribution partners network nationwide.
Our purpose For Every Life, For Every Future is to provide simple and accessible financial and health solutions to every generation.
PAMB was established in Malaysia in 1924 and is a subsidiary of Prudential plc, which was founded in London in 1848. Prudential plc provides life and health insurance and asset management, with a focus on Asia and Africa.
This year, we are proud to celebrate Prudential’s 100th anniversary in Malaysia.
Source: prudential.com