Claims Administrator

19 hours ago

PSA Kuala Lumpur Menara Prudential TRX F, Malaysia Prudential Full time 40,000 - 60,000 per year

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.

In this role, you will review, assess and approve group insurance claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, Enterprise Business Operations and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirements.

-   Adjudicate Health and medical claims and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time).

-   Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.

-   Review workflow and claims processes to identify areas of improvement and implement enhancement to achieve efficient claims administration.

-   Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met.

-   Manage working relation with external parties – Central Provident Fund Board (CPFB), regulator, financial consultants, bancassurance partners, medical institutions, etc.

-   Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment.

-   Manage enquiries, service recovery, complaints and appeal arising from claims.

-   Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status.

Who we are looking for:
Competencies & Personal Traits

• Strong command of the English language (spoken and written)

• Familiarity with human anatomy, general diseases and disease management

Working Experience

•   2 to 3 years of working experience in medical claims processing

Education

• Diploma or Degree

Language

• English

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

  • PBTB | Head of Claims

    3 days ago

    PBTB | Kuala Lumpur - Menara Prudential /F (TRX), Malaysia Prudential Full time 120,000 - 180,000 per year

    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...

  • Senior Manager Claims Projects, Systems

    20 hours ago

    PBTB | Kuala Lumpur - Menara Prudential /F (TRX), Malaysia Prudential Full time 120,000 - 240,000 per year

    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...

  • Claims Administrator

    1 week ago

    Kuala Lumpur, Malaysia MS Amlin Full time

    **Claims Administrator**:**Kuala Lumpur**: **Division**:MS AUL Claims **Department**:Claims Shared Services **Reports To**:Assistant Claims Manager **1. Purpose** Working as a member of the Claims team, the Claims Administrator supports the efficient and effective processing of activities which support the on-going management of an open claims portfolio...

  • Executive, Enterprise Business Operations

    3 days ago

    PSA | Kuala Lumpur - Menara Prudential @ TRX F, Malaysia Prudential Full time 30,000 - 60,000 per year

    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...

  • Claims Administrator

    20 hours ago

    Kuala Lumpur, Malaysia Prudential plc Full time

    Claims Administrator 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...

  • Claims Administrator

    19 hours ago

    Kuala Lumpur, Kuala Lumpur, Malaysia Nexacore Full time 30,000 - 60,000 per year

    About UsNexacore is an innovative third-party administrator providing sustainable solutions for insurance companies. We specialise in device protection, extended warranty, repair network management, and claims administration services, with a focus on delivering superior customer experiences through our advanced digital platforms.Role OverviewWe are seeking a...

  • Claim Administrator

    20 hours ago

    Kuala Lumpur, Malaysia Sedgwick Full time

    Claim Administrator Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's...

  • Manager, Customer Promise

    3 days ago

    PAMB | Kuala Lumpur - Menara Prudential /F (TRX), Malaysia Prudential Full time 120,000 - 240,000 per year

    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...

  • Assistant Manager, Customer Promise

    3 days ago

    PAMB | Kuala Lumpur - Menara Prudential /F (TRX), Malaysia Prudential Full time 45,000 - 60,000 per year

    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...

  • Claim Administrator

    20 hours ago

    Kuala Lumpur, Malaysia Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...