Claims Consultant

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.

Job Profile Summary

In this role, you will review, assess and approve shield claims within service turnaround time. As part of this dynamic role, you will report to Team Lead, PruShield Claims and work closely with various stakeholders to ensure that the output is accurate and compliant to internal policy and regulatory requirement and meet service objectives.

Job Description

• Review, assess and approve shield claims within service turnaround time.
• Ensure output is accurate and compliant to internal policy and regulatory requirement and meet service objectives.
• Manage claims investigation.
• Attend to service recovery, complaint, appeal, enquiry.
• Coach, supervise and guide subordinates in providing accurate and prompt services to advisers and claimants.
• Conduct medical claims technical workshops for agency force.
• Identify process shortcomings and implement improvement.
• Plan and organize resource and headcount for business needs.
• Manage working relation with external parties – CPFB, auditor, regulator, agency leaders, bancassurance partners.

Who We Are Looking For

Competencies & Personal Traits

• Team player, mature, with excellent leadership quality.
• Good knowledge of hospital admission, discharge and claims processes.
• Good medical knowledge and claims settlement procedure.

Working Experience

• Former medical practitioner experience as doctor, nurse, health therapist or healthcare provider will be an added advantage.
• At least 5-7 years of experience in managing claims operations.

Professional Qualifications

• LOMA certified or equivalent.

Education

• Degree with good credit in English and Mathematics.

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.

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