Executive, Customer Promise

4 weeks ago

Kuala Lumpur, Malaysia Prudential plc Full time

Executive, Customer Promise - Medical Reimbursement & Accident

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.

Principal Duties & Responsibilities:

- Adhering to the claims workflow in relation to Accident and Hospitalization claims procedure.
- Assess and provide justifiable claims according to policy terms and conditions, within the department benchmark, turnaround time and authority limit.
- Ensure claims appeal, referral or complaint from any parties are attended to and respond within the benchmark set by the department.
- Ensure and monitor claims processing to be within the department benchmark and turnaround time.
- Closely up on outstanding cases.
- Attend to & handle enquiries from internal staff, branch staff, agents, policyholders/claimants and queries from other insurance companies and ensure the respond within the benchmark set by the department.
- Correspond both internally and externally (inclusive but not limited to agents, policyholders, employer, private investigator, FMB and BNM) in order to handle day to day operation functions of the department, and coordinate with other departments, where applicable.
- Record, update, review, prepare and submission of statistics or reports, as required by the Management within the agreed service standards.
- Continuously review processes, identify and resolve any gaps through constructive feedback, and implement process improvement, where appropriate; update/document the administrative rules and processes for effective and efficient operation of the section.
- Continuously attend and involve with training for personal and career development.
- Conduct internal & external training in claims related matters, as and when required.
- Undertake projects or any other work and duties allocated by the Management or involve in Claims Department matters, as and when required.

**Principal Duties & Responsibilities:
- Adhering to the claims workflow in relation to Accident and Hospitalization claims procedure.
- Assess and provide justifiable claims according to policy terms and conditions, within the department benchmark, turnaround time and authority limit.
- Ensure claims appeal, referral or complaint from any parties are attended to and respond within the benchmark set by the department.
- Ensure and monitor claims processing to be within the department benchmark and turnaround time. Closely
- up on outstanding cases.
- Attend to & handle enquiries from internal staff, branch staff, agents, policyholders/claimants and queries from other insurance companies and ensure the respond within the benchmark set by the department.
- Correspond both internally and externally (inclusive but not limited to agents, policyholders, employer, private investigator, FMB and BNM) in order to handle day to day operation functions of the department, and coordinate with other departments, where applicable.
- Record, update, review, prepare and submission of statistics or reports, as required by the Management within the agreed service standards.
- Continuously review processes, identify and resolve any gaps through constructive feedback, and implement process improvement, where appropriate; update/document the administrative rules and processes for effective and efficient operation of the section.
- Continuously attend and involve with training for personal and career development.
- Conduct internal & external training in claims related matters, as and when required.
- Undertake projects or any other work and duties allocated by the Management or involve in Claims Department matters, as and when required.

Job ID 24040144

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