Executive, Claims

Prudential Hong Kong Limited; Kuala Lumpur; On-site; MYR 50,000 - 70,000; Full time

Job summary

A financial services company in Kuala Lumpur is seeking an Executive, Claims to provide dedicated claims services. The ideal candidate will adjudicate A&H claims, ensuring compliance with regulations, while managing claims investigations. Candidates should have 1-2 years of experience and a strong command of English. Basic Chinese skills are advantageous. This role emphasizes excellent communication and customer-centricity, supporting career growth and successful operations.

Qualifications

• At least 1-2 years of experience as a Life & Health claims assessor.
• Strong command of English language.
• Basic Chinese will be advantageous.

Responsibilities

• Adjudicate Accident & Health (A&H) claims ensuring compliance with regulations.
• Manage claims investigation with various stakeholders.
• Follow up on outstanding requirements for claims adjudication.
• Work closely with other business units to ensure accurate processing.
• Manage enquiries and appeals arising from claims.
• Support team in system enhancements or projects.

Skills

Excellent communication skills

Interpersonal skills

Problem-solving

Customer-centric

Ability to work under pressure

Leadership quality

Good medical knowledge

Job description

Executive, Claims page is loaded## Executive, Claimslocations: Kuala Lumpur (Group Head Office)time type: Full timeposted on: Posted Todayjob requisition id: 25090391Prudential’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 Description Summary ROLE PURPOSE: • Provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management.Job Description ROLE DUTIES & RESPONSIBILITIES: This role is accountable and responsible for the following: • Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level. • Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms. • Manage claims investigation by working with claimants, financial consultants, medical institutions, insurers, etc to determine claims decision and payment. • Follow up on outstanding requirements needed for claims adjudication through documented follow-up process and provide regular update on claims status. • Work closely with other business units to ensure that claims are processed accurately and that all service level agreements are met. • Manage enquiries and appeals arising from claims. • Support the team in implementing system enhancements or projects. This involves translating business requirements into test scenarios and performing user acceptance testing. KEY PERFORMANCE INDICATORS: Improving the customer's Instant experiences on claims by: • Ensuring that the claims are processed within the expected service level; • Attaining the benchmarked targets for productivity, claims pending rate, suspense management rate Additional Job Description Competencies & Personal Traits • Excellent communication, interpersonal and problem-solving skills with ability to investigate, evaluate and reach an appropriate decision • Customer-centric with ability to work under pressure • Self-motivated and able to work independently • Team player, mature, with excellent leadership quality. • Good medical knowledge and claims settlement procedure. • Ability to read basic Chinese will be advantageous Working Experience • At least 1-2 years of experience as a Life & Health claims assessor Language • Strong command of English language • Basic Chinese will be advantageous **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.Prudential plc provides life and health insurance and asset management to 18 million customers across 24 markets in Asia and Africa.We are headquartered in London and Hong Kong and are focused on four strategic regions: Greater China, ASEAN, India and Africa. We are served by around 68,000 average monthly active agents and more than 200 bank partners.Prudential plc is not affiliated in any manner with Prudential Financial, Inc., a company whose principal place of business is in the United States of America or with the Prudential Assurance Company, a subsidiary of M&G plc, a company incorporated in the United Kingdom.Find out more atFollow us on LinkedIn