Executive, Group Claims

8 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 provide efficient and effective support to the Company goals by meeting and exceeding their expectations on operational processes. The complexity of the insurance business requires the incumbent to acquire a thorough knowledge of the different insurance products (and their functionalities / technicalities) and operational processes to ensure customer’s enquiries are resolved in accordance with agreed service levels. The incumbent is also required to work closely with other operations departments in delivering excellent service quality to customers.

Adhering to the claims workflow in relation to Group Employee Benefit and Telemarketing 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 follow 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



  • Kuala Lumpur, Malaysia The Cigna Group Full time

    Claims processing - Processing claims under GEH APAC book of business - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. - Following up his/her own...

  • Claim Representative

    8 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    Claims processing_ - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. - Following up his/her own workload (volume and timing): keeping an eye on...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    Job content Claims processing - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. - Following up his/her own workload (volume and timing): keeping an eye...


  • 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...


  • 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...

  • Claims Representative

    6 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...

  • Claims Representative

    6 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific. Cigna Global Health Benefits (CGHB) is an integral part of Cigna's growing...

  • Claims Representative

    7 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific. Cigna Global Health Benefits (CGHB) is an integral part of Cigna's growing...

  • Claims Representative

    4 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific. Cigna Global Health Benefits (CGHB) is an integral part of Cigna's growing...

  • Claims Representative

    7 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    **Scope** Critical analysis and processing of claims for medical expenses within the fixed turn-around time. **Job content** **Claims processing** - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost...

  • Claims Representative

    7 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    Scope Critical analysis and processing of claims for medical expenses within the fixed turn-around time. Job content Claims processing - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in...

  • Claims Representative

    7 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    **Scope** Critical analysis and processing of claims for medical expenses within the fixed turn-around time. **Job content**: - Claims processing_ - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost...

  • Claims Representative

    7 months ago


    Kuala Lumpur, Malaysia The Cigna Group Full time

    **YOUR JOB** As a Claims Representative you will be part of Provider Services department, handling multiplatform processing and adjusting of provider claims which will be identified through the reconciliation output. You will report directly into the supervisor and will work closely with your peers in the same as well as others locations across the globe....

  • Claim Supervisor

    7 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 -...


  • Kuala Lumpur, Malaysia AIA Group Full time

    **At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.** **If you believe in developing a better tomorrow, read on.** **WE ARE LOOKING FOR.....**This role is designed for great talents that are passionate about claims analytics, BI visualization, AI & ML and data management. The job holder is responsible...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific. Cigna Global Health Benefits (CGHB) is an integral part of Cigna's growing...


  • 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 Allianz Malaysia Full time

    **Are you looking for something different instead of more of the same?** In your new role, you will process health claims while ensuring that our department’s strategic initiatives support the company’s mission and business goals, with a focus on risk mitigation and fraud prevention. **You'll be responsible for**: - Processing and assessing health...


  • Kuala Lumpur, Malaysia The Cigna Group Full time

    Critical analysis and processing of claims for medical expenses within the fixed turn around time. **Job content** - Claims processing_ - Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. - Positioning him/herself analytically and critically in the context of cost management and in...