Executive, Customer Promise - Healthcare Claims
Prudential
- Kuala Lumpur
- Permanent
- Full-time
- Adhering to our claim workflow in relation to hospitalization claims procedure.
- Assess and provide justifiable claims according to policy terms and conditions to our valued policy holders.
- Approving claims within the department benchmark/turnaround time and authority limit
- Recommend for claim approval/repudiation
- Ensuring customers enquiry from all source of referrals are promptly attended to and resolves via appropriate communication mode.
- To ensure and monitor claims processing benchmark and turnaround time
- To correspondences on and day to day operation functions of the department and coordinates with other departments
- To handle incoming enquiries from internal or external parties via emails, phone calls and portal.
- Updating and submission of reports as required by management within the agreed service standards.
- Liaise with Prudential Malaysia’s IT division to troubleshoot issues / cases encountered in the day to day operations.
- Continuously review and update/document the administrative rules and processes for effective and efficient operation of the section.
- Continuously attend / involve with training for personal and career development.
- Undertake projects / other work and duties allocated by Management, as and when required
- Ensuring that Financial Services Act (FSA), Bank Negara Malaysia, Anti-Money Laundering & Counter-Financing of Terrorism (AML/CFT) efforts, LIAM guidelines and internal guidelines are strictly complied with as applicable.