Executive, Claims-1

Provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management. Adjudicate Group Major Claims (Death, TPD, Critical Illness, Disability, Terminal Illness, etc) and Group Medical Claims (Hospital & Surgical, Major Medical, Outpatient Specialist, Outpatient Clinical, Dental, etc) and ensure delivery of prudent and equitable claims decision within expected service level. Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms. Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met. Manage working relation with external parties – Central Provident Fund Board (CPFB), medical institutions, TPAs, etc. Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment. Manage enquiries, service recovery, complaints and appeal arising from claims. Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status. Any other ad-hoc assignment assigned. Competencies include detail-orientation, accuracy, innovation, resilience, strong English communication, conflict resolution, customer-centricity, independence, and teamwork. Working Experience required: 2 to 3 years in life and medical claims processing. Education: Diploma or Degree. Prudential is an equal opportunity employer with inclusive policies across multiple regions.