Pbtb Executive, Claims

5 months ago

Kuala Lumpur, Malaysia Prudential plc Full time

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.

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