Job Description

Prudentials 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 peoples career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.
JOB SCOPE:
The incumbent is responsible to manage an efficient and effective Claims team by meeting and exceeding managements 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 customers 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.
Position Summary:
xefx82xa7 Claims Approval within authority limit
xefx82xa7 Claims Recommendation to the next Level
xefx82xa7 Planning overall strategy of the Unit
xefx82xa7 Managing the day to day functions of the Unit which include people, system, procedures and others.
PRINCIPAL DUTIES & RESPONSIBILITIES:
xefx82xa7 Appraising claims up to a company-specified approval limit.
xefx82xa7 Strategic planning, managing, coordinating, controlling and monitoring the Unit plans to ensure that the operational objectives of the department and the company are being met.
xefx82xa7 Responsible in ensuring appropriate measures and controls on claims leakages and fraud management, monitoring of legal cases are adhered to.
xefx82xa7 Assessing critical legal and industry issues on claims with high ambiguity and exposures to the company.
xefx82xa7 Ensuring that Insurance Act, Bank Negara Malaysia, Anti-Money Laundering & Counter-Financing of Terrorism (AML/CFT) efforts, LIAM guidelines and internal guidelines are strictly complied with as applicable.
xefx82xa7 Applying complicated theory and fundamentals of claims appraisals.
xefx82xa7 Ensuring company-specific claims policy and guidelines are in line with Prudential Malaysia Claims policy and standards. This includes defining and implementing standards for accuracy, productivity and timeliness as well as recommending strategies to meet those standards.
xefx82xa7 Reviewing and revising claims guidelines regularly to ensure that they are aligned with changes in the market, legal and regulatory environments, and product design.
xefx82xa7 Supervising the performance of subordinates.
xefx82xa7 Representing the department head in meetings.
xefx82xa7 Implementing projects for the streamlining of operations or improvement of servicing capabilities.
xefx82xa7 Determining appropriate training for subordinates to ensure that they are keeping up with market and business requirements.
REQUIREMENTS:
Education : Degree in Biology/Biomedical Science/Business Administration/Mathematics/Economics/
Statistics and/or a professional life insurance qualification .e.g. ACII, AMII, AAII, FLMI, etc..
Experience : 10 years of experience in claims including 5 years at a managerial level, 5 years
in insurance claims administration and assessment (all claim types) and in-
depth knowledge of the insurance industry and Life/Group insurance claims.
KSAs : Well versed in Life/Group Products is a must.
: Knowledge on laws & regulations governing the insurance industry is highly essential.
: Equipped with insurance knowledge & technical know-how on the fundamentals of
Life Insurance.
: Able to communicate & interact efficiently with internal & external customers.
: Possess a good work ethic & professionalism is practiced in every single time.
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.