Assistant Manager, Customer Promise - Medical Reimbursement & Accident | Kuala Lumpur, MY

Prudential plc; Kuala Lumpur; On-site; MYR 50,000 - 75,000; Full time

Job summary

Join Prudential as an Assistant Manager, focusing on enhancing customer experiences in medical claims. You will manage inquiries, improve relationships, and ensure compliance with industry standards. This role offers a chance to advance in a dynamic environment dedicated to diversity and inclusion.

Qualifications

• Experience in handling inquiries and complaints.
• Strong understanding of insurance policies and claims processes.
• Ability to analyze data and produce reports.

Responsibilities

• Manage feedback and claim inquiries for medical claims.
• Improve relationships and awareness of contractual benefits.
• Ensure compliance with legal and regulatory standards.

Skills

Customer Service

Conflict Resolution

Communication

Analytical Skills

Job description

Assistant Manager, Customer Promise - Medical Reimbursement & Accident

Prudential's purpose is to be partners for every life and protectors for every future. Our culture celebrates diversity and inclusion, supporting our people to do their best work and advance their careers. We aim to make Prudential a place where you can Connect, Grow, and Succeed.

Principal Duties & Responsibilities:

1. Handle incoming feedback, appeals, and claim inquiries from internal or external parties via emails, phone calls, and escalations from higher management.
2. Manage CRM, Ask Me RAISe inquiries, and emails at [e-mail], ensuring proper closure within the agreed TAT.
3. Improve agent and customer relationships, create awareness about contractual coverage, benefits, claims adjudication, and reasons for repudiation, limited to medical claims.
4. Resolve queries from agents and others within authority limits, investigate complaints, gather information from the claims department, and review supporting documents.
5. Make fair, impartial decisions on complaints in line with company and regulatory frameworks, ensuring fairness to all customers.
6. Gather customer and agency feedback to enhance claims service standards and customer experience where appropriate.
7. Ensure compliance with legal requirements, industry regulations, organizational policies, and professional codes of conduct.
8. Update and submit reports as required by management within the specified standards.
9. Review and update administrative rules and processes (e.g., SOP) for operational efficiency.
10. Acknowledge complaints promptly, follow up systematically, and respond within set time limits.
11. Participate in training for personal and career development.
12. Provide ongoing training to subordinates on claim assessment processes, especially for minor reimbursement claims.
13. Summarize actions required, advise agents or customers on timelines, and draft correspondence.
14. Undertake projects or other duties as assigned by management.
15. Analyze daily CT/MT tickets, Ask Me RAISe inquiries, and claims appeals monthly to ensure quality in operations.
16. Identify errors in claim assessments/decisions, escalate issues, and provide feedback for improvement.
17. Identify process/system gaps, propose solutions, and escalate for system fixes or process changes.

Prudential is an equal opportunity employer. We provide equal benefits and opportunities regardless of sex, race, age, ethnicity, education, social background, marital status, pregnancy, religion, disability, or employment status. We support reasonable adjustments for individuals with health requirements.

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