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Executive, Claims

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This job is an Executive, Claims role at Prudential, where you help process claims and support customers. You might like this job because it combines problem-solving and teamwork, all while making a positive impact on people's lives.

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.

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:

Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level.

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

Manage claims investigation by working with claimants, financial consultants, medical institutions, insurers, etc to determine claims decision and payment.

Follow up on outstanding requirements needed for claims adjudication through documented follow-up process and provide regular update on claims status.

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

Manage enquiries and appeals arising from claims.

KEY PERFORMANCE INDICATORS:

Improving the customer's Instant experiences on claims by:

Ensuring that the claims are processed within the expected service level;

Attaining the benchmarked targets for productivity, claims pending rate, suspense management rate

Additional Job Description

Competencies & Personal Traits

Excellent communication, interpersonal and problem-solving skills with ability to investigate, evaluate and reach an appropriate decision

Customer-centric with ability to work under pressure

Self-motivated and able to work independently

Team player, mature, with excellent leadership quality.

Good medical knowledge and claims settlement procedure.

Ability to read basic Chinese will be advantageous

Working Experience

At least 1-2 years of experience as a Life & Health claims assessor

Language

Strong command of English language

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.


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

Job Specialisation


Company Profile

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Prudential plc

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...