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 limitPRINCIPAL 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- Updating and submission of reports as required by management within the agreed service standards.- Liaise with Prudential Malaysia's 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.ExperiencePreferably experience in HealthCare, financial institutions, i.e. Banks, Insurance for at least 1 YearFresh graduate can be considered.KnowledgeLife Insurance background, preferably in Health, Accidental & or Life Claims
