Healthcare Claims Specialist

4 days ago


Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Assurance Malaysia Berhad Full time

Our company, Prudential Assurance Malaysia Berhad, strives to be a leader in the insurance industry by providing excellent customer service and promoting a culture of inclusion and diversity.

Key Responsibilities
  • Main Duties:
  • Comply with claim workflow procedures related to hospitalization claims handling.
  • Determine and justify claims based on policy terms and conditions.
  • Authorize claims within departmental benchmarks and turnaround times.
  • Make recommendations for claim approval or rejection.
  • Address customer inquiries from various sources in a timely manner using suitable communication methods.
  • Promote efficient claims processing and adherence to turnaround times.
  • Foster collaboration between departments through daily operational correspondences.
  • Manage customer communications through multiple channels.
  • Provide regular reports to management within specified service standards.
  • Collaborate with IT division to resolve technical issues.
  • Regularly review and update administrative procedures for optimal efficiency.
  • Pursue training opportunities for personal and professional growth.
  • Perform assigned tasks and projects as directed by management.
  • Ensure compliance with regulatory requirements, including FSA, Bank Negara Malaysia, AML/CFT, and internal guidelines.

We embrace diversity and promote equal opportunities for everyone who applies and works for our organisation.



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