Healthcare Claims Specialist
4 days ago
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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