Senior Officer - Pre-Authorisation and Minor Claims

Prudential Services Asia; Kuala Lumpur; On-site; MYR 45,000 - 78,000; Full time

Job summary

Prudential Services Asia is seeking a claims professional to handle minor and pre-authorization claims within delegated authority, ensuring SLA and medical guideline compliance. You will participate in UAT and support maker-checker processes.

You will handle inquiries from customers and agents, sign payment letters, follow up on documents, and assist with pre-authorisation and major cases, while upholding Prudential’s equal-opportunity principles.

Qualifications

• Experience in claims handling and pre-authorization preferred.
• Knowledge of SLAs and medical guidelines.
• Experience with maker-checker controls.

Responsibilities

• Handle minor and pre-authorization claims within delegated authority.
• Respond to inquiries from customers, agents, and staff; sign payment letters and follow up on documentation.

Job description

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.

• 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.

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. We are Prudential. For every life, we are partners. For every future, we are protectors.

Prudential plc provides life and health insurance and asset management to 17 million customers across 20 markets in Asia and Africa. We are headquartered in Hong Kong and have dual primary listings on the Stock Exchange of Hong Kong and the London Stock Exchange. We are focused on four strategic regions: Greater China, ASEAN, India and Africa. Our customers are served by around 55,000 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 at www.prudentialplc.com Follow us on LinkedIn