Claims Technical Excellence Director

5 days ago


Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

The Claims Technical Excellence Director will be responsible for Medical Claims Fraud, Waste and Abuse (FWA) detection and Claims Avoidance Rate in Prudential to ensure long-term sustainability of the portfolio. With strong knowledge in medical and insurance processes, this individual will perform training and audits, maintain system rules and guidelines to equip the Claims Department with the capability to eliminate leakages.

Key Accountabilities:
  1. Manage and perform claims review on claims assessors' cases as part of the claims authority upgrade process.
  2. Work closely with other departments and vendors in delivering a robust Claims process flow.
  3. Support improvement in SLA and minimize penders through identifying improvement opportunities, automation, streamlining processes & guidelines.

We are dedicated to making Prudential a place where you can Connect, Grow, and Succeed.



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