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.

The incumbent is responsible to manage an efficient and effective Claims team by meeting and exceeding management’s expectations on operational processes.  The complexity of the insurance business requires the incumbent to acquire a thorough knowledge of the different insurance products (and their functionalities / technicalities) and operational processes to ensure customer’s enquiries are resolved in accordance with agreed service levels.  The incumbent is also required to work closely with other operations departments in delivering excellent service quality to customers.

The incumbent is also to participate actively in delivering cost containment and that genuine claims are paid expediently. The position requires active involvements in managing medical claims costs down through dialogues, discussions, educations, training, communications to all parties who are stakeholders of the product; i.e. the policyholders, agents, hospitals administrators, doctors etc.

PRINCIPAL DUTIES:

• Deliver end to end Customer Journey and provide exceptional PRUexperience Service to our customers.
• Fulfill the Claims Philosophy by paying all valid claims quickly.
• Treat all our customers with compassion and care.
• Keep our Customers well informed on the progress of their Claims regularly along the journey.
• Serve our customers exceptionally well during their life’s difficult moment by making it simple and easy when handling their Claims.
• Be consciously aware that our customers are awaiting our decisions, therefore resolve their claims quickly without unnecessary requirements.
• Close collaboration with co-workers from all areas within the organization focusing to resolve Customers’ requests without delay.
• Provide exceptional customers’ experience during their moment of truth with us while ensuring that we are in full compliance of Company’s governance and best practices, local regulations and Group’s standards and guidelines.

RESPONSIBILITIES:

• Medical Reimbursement & Personal Accident Claims
• CRM Management
• Pre/ Post / Reimbursement Claims
• Collaboration with QA/ QL/ Clients
• Complaints handling and resolution
• Claims Investigations
• Penders Management
• E2E Status / Progress Update
• Interdepartmental follow through
• Active Resolution time follow up
• Smart claim delivery

JOB SPECIFICATION 

Qualification
University Degree with a focus in Business, Accounting, Risk Management (Insurance) or other related disciplines

Experience

Minimum 8 years of experience in claims including 5 years at managerial level, 5 years in insurance claims administration and assessment (all claim types) and expert knowledge of the insurance industry and insurance claims. Expert level in managing a large team of people. Preference for those with experience in underwriting, medical or legal aspects of claims.

Knowledge                      

• Strong command of English and Bahasa Malaysia (spoken and written)
• Mastery of insurance concepts, principles and terminology
• Mastery of claims concepts, principles and procedures
• Mastery of underwriting concepts, principles and general procedures
• Mastery of company procedures for responding to customer complaints when dealing with claims
• Mastery of products offered by the company
• Mastery of management principles
• Mastery of the company’s claims philosophy
• Mastery of Bank Negara guidelines for the insurance industry
• Mastery of the company’s standard of ethics.

Behavioral Competencies

• Professional integrity
• Flexibility
• Presentation skills
• Decision making skills
• Participate in negotiations
• Resolve disputes
• Planning and organizing
• Influencing
• Providing feedback
• Coach, motivating and developing others
• Team oriented
• Provide leadership across the organization
• Emotional Intelligence
• Building people capability
• Manage budgets and financial plans within the work team
• Delegating and holding people accountable
• Ability to deal with complexity
• Resource management
• Driving results
• Leading change

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