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.

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 (i.e. claims turnaround time).
• Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.
• Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.
• Manage working relation with external parties \xe2\x80\x93 Central Provident Fund Board (CPFB), regulator, financial consultants, bancassurance partners, medical institutions, etc.
• Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment.
• Manage enquiries, service recovery, complaints and appeal arising from claims.
• Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.
• Coach and mentor junior staff
• Conduct claims technical workshops for agency force

KEY PERFORMANCE INDICATORS:

Improving the customer\'s Instant experiences on claims by:

• Ensuring that the claims are processed within the expected service level (i.e. claims turnaround time);
• Attaining the benchmarked targets for productivity, claims pending rate, suspense management rate

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.

Working Experience

• At least 3-5 years of experience in managing claims operations

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