Pbtb Executive, Claims

4 weeks ago

Kuala Lumpur, Malaysia Prudential plc Full time

PBTB | Executive, 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.

The incumbent is responsible to process HAS cases efficiently by meeting and exceeding management's expectations, technically and operationally.

**Roles & Responsibilities**
- Validate the information stated in the Pre-Authorization Form completed by the client and attending doctor, assess the request, calculate the correct amount coverable and make a correct decision accordance to benefit terms & Claims SOP.
- Ascertain the accurate data entry such as ICD10 Diagnosis Code, Surgery and Consultation Code (per PHA Schedule) and items charged per bills issued by hospital.
- Process Pre & Final -Authorization Letter request within the agreed Service Level accordance to daily productivity target.
- Participate in product and technical trainings as well as work with supervisor for additional training plans in acquiring and improving industry or technical knowledge.
- Ensures compliance with all regulatory (internal and external) and corporate requirements.
- Manage customer/ agent/ hospital enquiries and provide feedback/response appropriately.

**Job Requirements**:

- A degree in Biomedical Science, Insurance and Risk Management or any field related to Insurance or Takaful, preferably with Life Science background.
- Possess in-depth knowledge of basic life products (inclusive of its functionalities/technicalities) and operational processes for at least 3 years will be an advantage.
- Customer focused with excellent problem-solving skills, the ability to work with a positive attitude & excel under pressure.
- Self-motivated, love challenges and working with people.
- Proficient in English both oral and in writing.

Job ID 24050218

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