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This job is for a Manager in Healthcare Claims at Prudential. Manage daily operations, staff productivity, and service standards. You might like this job because it offers the opportunity to optimize operations and make impactful decisions.
Undisclosed
Full-Time
few days 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:
· Responsible for daily work and ensuring that the daily operations with good analysis on impact and act strategically in optimizing the operation capacity to meet the business goal set forth as the service standard level.
· Analyze staff’s productivity daily and compilation in staff’s monthly productivity, review & reports with constructive feedback, and implement action plans by identifying underlying course to improvements where appropriate.
· Makes good & sound decision during uncertain and difficult context to minimize the disruption on operation and continuously review processes, identify and resolve service gaps through constructive feedback, and implement process improvements where appropriate.
· Ensuring all claim examiners in the Healthcare Claims unit meets all type of service standards (benchmark and TAT) each month.
· Provide justification for not meeting the monthly service standard.
· Analyze cause of problem affecting processing and recommend alternative solution.
· Ensuring justifiable decision on hospitalization claims within Turnaround time.
· To process claim with recommendation for settlement and approval within the department benchmark.
· To handle queries from agents and insured and prospect customers via phone calls, faxes and e-mails.
· To correspondences on and day to day operation functions of the department and coordinates with other departments.
· Claims appeal from insured and agent to be attended and respond within the benchmark set by the department.
· Responsible in relation to customer’s enquiry in order to maintain a high level of quality service to customer and record, produce and prepare any statistics and information required by the Management in relation to the customer enquiry and progress.
· Monitoring and analyzed the occurrences of incidences on the occurrences required with simple performance-based reports of individual staffs identified and log in the action plan, progress of the action taken inclusive monetary recovery and coverage based on ex-gratia on the occurrences filed.
· Responsible for staff’s development in training and re-training as and when required by identifying the base line of staff’s assessment skills and the reports of occurrences in staff’s assessment skills.
· To conduct workshops with agency force in training technical understanding of product from the aspect of Claims (HAS Facility)
· Performance miscellaneous job-related duties and projects assigned by superior.
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 - 1 hour 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