Claims Administrator

5 months ago


Kuala Lumpur, Malaysia Prudential plc Full time

Claims Administrator

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.

In this role, you will review, assess and approve group insurance claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, Enterprise Business Operations and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirements.
- Adjudicate Health and medical claims and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time).
- Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.
- Review workflow and claims processes to identify areas of improvement and implement enhancement to achieve efficient claims administration.
- Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.
- Manage working relation with external parties - Central Provident Fund Board (CPFB), regulator, financial consultants, bancassurance partners, medical institutions, etc.
- Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment.
- Manage enquiries, service recovery, complaints and appeal arising from claims.
- up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.

Who we are looking for:
Competencies & Personal Traits
- Strong command of the English language (spoken and written)
- Familiarity with human anatomy, general diseases and disease management

Working Experience
- 2 to 3 years of working experience in medical claims processing

Education
- Diploma or Degree

Language
- English

Job ID 23080453


  • Claim Administrator

    5 months ago


    Kuala Lumpur, Malaysia Sedgwick Full time

    Claim Administrator Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's...

  • Claim Administrator

    5 months ago


    Kuala Lumpur, Malaysia Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...


  • Kuala Lumpur, Malaysia Chrisjac Recruitment Services Full time

    **Position: Insurance Claims Executive.**: - **Salary: RM 4000-5000.**: - **Job location: City center (5-day week), Kuala Lumpur.** Chrisjac is currently seeking individuals who are interested in Executive Claims administration position for an established insurance company in Kuala Lumpur. This position would be based at their Motor Claims Department...

  • Claims Administrator

    5 months ago


    Kuala Lumpur, Malaysia Techsap ASP Sdn Bhd Full time

    **Job Summary**: Responsible in leading retail claims daily operation process efficiently. **Main Responsibility**: - Ensure the daily operation process to be achieved and meeting the turnaround time set. - Ensure the team's compliance to all regulations, controls and internal policies including audit. - Resolve escalation case by the staff and/or...

  • Claims Manager

    5 months ago


    Kuala Lumpur, Malaysia Aon Corporation Full time

    Claims Manager **Claims Manager, Professional Indemnity Insurance (PII) Scheme for Lawyers** **Aon is in the business of better decisions** At Aon, we shape decisions for the better to protect and enrich the lives of people around the world. As an organization, we are united through trust as one inclusive, diverse team, and we are passionate about...

  • Claims Manager

    5 months ago


    Kuala Lumpur, Malaysia Aon Corporation Full time

    Posting Description: **Claims Manager, Professional Indemnity Insurance (PII) Scheme for Lawyers** **Aon is in the business of better decisions** At Aon, we shape decisions for the better to protect and enrich the lives of people around the world. As an organization, we are united through trust as one inclusive, diverse team, and we are passionate about...


  • Kuala Lumpur, Malaysia Goodterm Alliance Sdn Bhd Full time

    **Motor Claims Processing Internship (Fresh Graduates or Zero Experience Welcome!)** **Internship with Potential for Full-Time Employment** Are you a detail-oriented and eager-to-learn recent graduate interested in the exciting world of insurance? **We're looking for motivated interns to join our growing claims processing team!** **Why Intern with Us?** -...


  • Kuala Lumpur, Malaysia Pacific Prime Insurance Brokers Sdn Bhd Full time

    Prepare, check and submit claim forms and related documentation Update claims status on internal system and platform Communicate with clients and handle enquiries on insurance coverage, claims, pre-authorization, etc. Liaise with insurance partners, clinics/hospitals, third-party administrators on claims matters Support on claims administration of...

  • Claims Executive

    5 months ago


    Kuala Lumpur, Malaysia AS White Global Pty Ltd Full time

    **The Opportunity** Our client is a well-established Australian firm with expertise in managing multinational accounts, iconic brands, high-net-worth individuals, and private businesses. They have over 60 years of experience and specialize in various industry sectors, providing risk management advice and maintaining a strong reputation in local and...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    POSITION : Claim Representative A REPORTING TO : Claim Supervisor or Manager DEPARTMENT : Claims Career Band : Band 1 JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing...

  • Claim Handling Officer

    6 months ago


    Kuala Lumpur, Malaysia HR FIRST Sdn Bhd Full time

    Position: Claim Handling Officer/ Operations Support Contract Duration: 6 months Office loocation: Menara Prudential TRX Description - Adhering to the claim’s 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...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    POSITION : Claims Representative REPORTING TO : Claims Senior Representative / Supervisor 1. JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of...

  • Claim Supervisor

    6 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    JOB PURPOSE Manages the accurate and timely adjudication of claims and administers disposition according to contractual benefits and company procedures. Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs. Responsible for monitoring claim service standards. 2. RESPONSIBILITIES AND DUTIES -...

  • Claims Representative

    5 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    **JOB DESCRIPTION**: **POSITION : Claim Representative** **REPORTING TO**: Claim Supervisor or Manager** **DEPARTMENT : Claims** **Career Band : Band 1** **JOB PURPOSE** The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    **JOB PURPOSE** The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain...


  • Kuala Lumpur, Malaysia Chrisjac Recruitment Services Full time

    **Position: Insurance Claims Executive.**: - **Salary: RM 4000-5000.**: - **Job location: City center (5-day week), Kuala Lumpur.** Chrisjac is currently seeking individuals who are interested in Executive Claims administration position for an established insurance company in Kuala Lumpur. This position would be based at their Legal Department responsible...


  • Kuala Lumpur, Malaysia Chrisjac Recruitment Services Full time

    **Position: Insurance Claims Executive,Motor insurance.**: - **Salary: RM 4000-5000.**: - **Job location: City center (5-day week), Kuala Lumpur.** Chrisjac is currently seeking individuals who are interested in Executive Claims/Adjuster position for an established general insurance company in Kuala Lumpur. This position would be based at their Motor...


  • Kuala Lumpur, Malaysia Chrisjac Recruitment Services Full time

    **Position: Claims Executive/Adjuster, Motor insurance.**: - **Salary: RM 4000-5000.**: - **Job location: City center (5-day week), Kuala Lumpur.** Chrisjac is currently seeking individuals who are interested in Executive Claims/Adjuster position for an established general insurance company in Kuala Lumpur. This position would be based at their Motor...


  • Kuala Lumpur, Malaysia Chrisjac Recruitment Services Full time

    **Position: Insurance Claims Executive-Motor insurance.**: - **Salary: RM 4000-5000.**: - **Job location: City center (5-day week), Kuala Lumpur.** Chrisjac is currently seeking individuals who are interested in Executive Claims/Adjuster position for an established general insurance company in Kuala Lumpur. This position would be based at their Motor...


  • Kuala Lumpur, Malaysia Allianz Full time

    AM, Claims Investigator **Summary** The Claims Investigator is responsible for all aspects of the investigation process to include creation of investigation plans, identification and assignment of relevant enquiries and reporting on findings. The investigator will provide assistance to the claims examiner in progress the claim and will leverage knowledge...