Senior Claims Specialist: Pre-Authorisation & Minor Claims

Prudential plc; Kuala Lumpur; Vor Ort; MYR 50.000 - 80.000; Vollzeit

Zusammenfassung

Prudential plc in Malaysia is seeking a Claims Handler to assess minor and pre-authorization claims, perform investigations when needed, and support the maker-checker framework. You will review SLAs, policy terms, and medical guidelines while assisting customers, agents, and internal staff.

This role offers opportunities to participate in UAT reviews, support pre-authorisation and major cases, and contribute to continuous improvement projects.

Aufgaben

• Handle and assess minor and pre-authorization claims within delegated authority, ensuring compliance with SLAs, policy terms, and medical guidelines.
• Participate in UAT script reviews and ad hoc projects.
• Handle minor or pre-authorization claims, issue GL within authority limit and refer larger claims to senior assessor for approval.
• Perform claims investigation where necessary.
• perform checker role under the maker and checker framework.
• Handle enquiries and complaints from customers, agents (including telephone and emails where necessary) and internal staffs.
• Check and sign payment letters and prepare non-standard payment and decline letters where necessary.
• Follow up on additional supporting documents to facilitate claim resolution.
• Participate in projects where necessary.
• Provide support to pre-authorisation and major cases if needed.

Jobbeschreibung

Prudential plc in Malaysia is seeking a Claims Handler to assess minor and pre-authorization claims, perform investigations when needed, and support the maker-checker framework. You will review SLAs, policy terms, and medical guidelines while assisting customers, agents, and internal staff.

This role offers opportunities to participate in UAT reviews, support pre-authorisation and major cases, and contribute to continuous improvement projects.