AI-generated summary
- Adjudicate group life & medical claims; investigate, decide and pay within SLAs.
- Purpose-driven firm protecting futures; inclusive culture and career support.
- Own complex claims, collaborate across teams and fast-track your career!
Undisclosed
Kuala Lumpur (Group Head Office), Kuala Lumpur
Job Description
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.Job Description:
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.
Job Requirements
Company Benefits
United through teamwork
Our teams are innovative, hands-on and collaborative. The power to share and collaborate requires respect, integrity and teamwork.
Open and collaborative culture
Our company is rooted in a rich heritage but to look to the future, we need new energy and perspectives.
Connect, Grow, Succeed
We are here to help our employees expand their skills and expertise in various areas.
Additional Info
Company Activity
Last active - few hours ago
Experience Level
0 - 10 Years of Experience
Company Profile
