Claims
2 weeks 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.
Responsible for evaluating and processing complex insurance claims, including inpatient and outpatient claims. This role involves detailed review of claim submissions, verification of information, and resolution of claims with a high degree of accuracy and efficiency. The Senior Officer also provides guidance and support to junior staff and contributes to the continuous improvement of claims processes
- Claims Review: Examine claim submissions including Inpatient and outpatient Claims to ensure all required documentation is provided and accurate within the specified turnaround time.
- Verification: Verify the authenticity of claims by cross-checking information with relevant sources.
- Communication: Liaise with claimants, medical professionals, and other stakeholders to gather necessary information including investigation.
- Documentation: Maintain detailed records of claims assessments and decisions.
- Support: Assist the Claims Manager in preparing reports and analyzing claim trends.
- Compliance: Ensure all claims are processed in accordance with company policies and regulatory requirements.
- Customer Service: Provide customer service to stakeholders, addressing their inquiries and concerns promptly.
- Leadership: Mentor and support junior staff, providing guidance and training as needed.
- Process Improvement: Contribute to the development and implementation of improved claims assessment processes
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Manager - Claims
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