Executive, Customer Promise

2 weeks ago

Kuala Lumpur, Kuala Lumpur, Malaysia Prudential plc Full time
Executive, Customer Promise - Healthcare Claims

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.

Executive, Customer Promise - Healthcare Claims

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
  • 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.
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