Claims Operations Lead - Customer Experience

Prudential Assurance Malaysia Berhad; Kuala Lumpur; On-site; MYR 40,176 - 66,960; Full time

Job summary

Prudential Assurance Malaysia Berhad is seeking a claims operations professional to support efficient processing of accident and hospitalization claims. The role requires knowledge of policy terms, adherence to workflow, and timely communication with policyholders.

The incumbent collaborates with IT and other departments to ensure service standards are met and reports are accurately prepared for management review. Equality and inclusion are core values of the organisation.

Qualifications

• Knowledge of insurance claims processes and policy terms.
• Attention to detail and accuracy in evaluating claims.
• Good communication and customer service skills.

Responsibilities

• Adhere to claims workflow for accident and hospitalization claims.
• Assess and provide justifiable claims according to policy terms.
• Approve claims within department benchmarks and authority limits.
• Recommend for claim approval or repudiation as appropriate.
• Handle customer inquiries via email, phone, and other channels.
• Monitor claims processing benchmarks and turnaround times.
• Coordinate with other departments for operational support.
• Liaise with IT to troubleshoot day-to-day issues.
• Update and submit reports as required by management.
• Review administrative processes for efficiency and accuracy.
• Attend training for personal and career development.
• Undertake projects and additional duties as required by management.

Job description

Prudential Assurance Malaysia Berhad is seeking a claims operations professional to support efficient processing of accident and hospitalization claims. The role requires knowledge of policy terms, adherence to workflow, and timely communication with policyholders.

The incumbent collaborates with IT and other departments to ensure service standards are met and reports are accurately prepared for management review. Equality and inclusion are core values of the organisation.