Claims Assessor (1 Year Contract)

PRUDENTIAL ASSURANCE COMPANY SINGAPORE (PTE) LIMITED; Singapore; On-site; SGD 45,000 - 65,000; Full time

Job summary

Prudential Assurance Company Singapore (PTE) Limited is seeking a Life & Health claims assessor to review, adjudicate and approve Accident & Health claims within defined service turnaround times.

You will report to the Team Lead, A&H Claims and work with claimants, medical institutions, insurers and consultants to ensure accurate and compliant decisions, while maintaining regulatory and corporate standards.

Qualifications

• Experience as Life & Health claims assessor.
• Strong communication and analytical skills.
• Ability to work under pressure and meet SLAs.
• Knowledge of policy wording and regulatory requirements.

Responsibilities

• Adjudicate Accident & Health (A&H) claims within service turnaround times.
• Ensure decisions are prudent, equitable, and compliant with internal policy and regulatory requirements.
• Coordinate with claimants, medical institutions, insurers and consultants to investigate and determine claims decisions.
• Follow up on outstanding requirements for adjudication and provide regular status updates.
• Collaborate with other business units to maintain accurate processing and meet SLAs.
• Handle enquiries and appeals arising from claims.

Skills

Communication skills

Interpersonal skills

Problem solving

Customer-centric

Independent worker

Team player

Medical knowledge

Job description

In this role, you will review, assess, and approve Accident & Health claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, A&H Claims and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirements.

Job Description:

• 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

Who we are looking for:

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 procedures

Working Experience

• At least 1-2 years of experience as a Life & Health claims assessor