Assistant Director Fwa
4 days ago
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.
Job Summary:
The incumbent is responsible to:
- Drive exceptional customer experience by providing fast & quality decision & enhancing skill set for complex medical areas & creating best in class claims service & framework
- Drive exceptional customer experience at Hospitals & panel clinics along with providing support for operational efficiency & long-term portfolio sustainability
- To create seamless customer experience at the point of delivering customer promise - claims by creating high degree of Automation
- Enable new health related offerings via Pulse, in line with latest trends and medical advancements
- To support long term sustainability of Insurance portfolio
- Creating efficiency by creating insights through Data analytics (Internal & External Data)
- Utilizing AI & analytics to create opportunities for growth & improvement
Principal
**Responsibilities**:
- Performing the role as a lead in managing staff and to ensure task assigned to team member complete within given time to meet expectations on operational processes.- To lead and coordinating the team member to achieve the company’s goal in providing support and guidance to Claims Department via assessor knowledge, guidelines, systems, technology, etc.- To support and provide analysis to internal stake holder in monitoring effectiveness and detect gaps to develop new initiatives and measures to achieve the goal.- Manage & provide claims training for claims assessors to ensure skills are continuously improved through external trainings or customized technical training program.- Provide and support claims training to other departments or business partners.- Manage and perform claims review on claims assessor’ cases as part of claims authority upgrade process.- Manage and report on claims/compliance audits to ensure quality assessment and compliance is achieved and identify any improvement areas.- Perform regular review of underwriting guidelines to ensure that it is relevant, competitive and to drive operational efficiency while maintaining good risk management and long-term sustainability of Portfolio.- To work closely with other departments and vendors in delivering robust Claims process flow.- Develop and maintain rules in the claims system for STP and identify opportunities that provide operational efficiency, support business growth and seamless customer experience.- Leverage on internal & external data to understand current state, trend and opportunities in improvement/growth area.- Support improvement in SLA and minimizing penders through identifying improvement opportunities, automation, streamlining processes & guidelines.- Support improvement in onboarding NPS through various initiatives, manage and monitor the team performance in meeting departmental service expectations and deliver excellent service quality to customer.- Participate in Roadshows, Quality leaders meeting and focus group dialog to gain insight and provide education on Medical Claims and FWA.
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