Job Description

Prudential\'s purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people\'s career ambitions. We pledge to make Prudential a place where you can Connect, Grow and Succeed.

JOB SCOPE:

The incumbent is responsible to provide efficient and effective support to the Company goals by meeting and exceeding their 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 claims 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 (on shift nature)

Position Summary:

• Claims Assessment
• Claims Recommendation
• Claims Approval within authority limit

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 source 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\xe2\x80\x99s 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.

JOB SPECIFICATION

Qualifications
Degree in Biomedical Science, Allied Health or Biology, Mathematics, Economics, Statistics, Business Administration, and etc.

Experience

Preferably experience in HealthCare, financial institutions, i.e. Banks, Insurance for at least 1 Year

Fresh graduate can be considered.

Knowledge

Life Insurance background, preferably in Health, Accidental & or Life Claims

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.

Prudential