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 Summary:The incumbent is responsible to:Drive exceptional customer experience by providing fast & quality decision & enhancing skill set for complex medical areas & creating best in class claims service & framework.
Drive exceptional customer experience at Hospitals & panel clinics along with providing support for operational efficiency & long-term portfolio sustainability.
Create seamless customer experience at the point of delivering customer promise - claims by creating high degree of Automation.
Enable new health related offerings via Pulse, in line with latest trends and medical advancements.
Support long term sustainability of Insurance portfolio.
Create efficiency by creating insights through Data analytics (Internal & External Data).
Utilize AI & analytics to create opportunities for growth & improvement.Principal Duties and ResponsibilitiesPerform the role as a lead in managing staff and ensure tasks assigned to team members are completed within the given time to meet expectations on operational processes.
Lead and coordinate team members to achieve the company's goal in providing support and guidance to Claims Department via assessor knowledge, guidelines, systems, technology, etc.
Support and provide analysis to internal stakeholders in monitoring effectiveness and detecting gaps to develop new initiatives and measures to achieve the goal.
Manage & provide claims training for claims assessors to ensure skills are continuously improved through external trainings or customized technical training programs.
Provide and support claims training to other departments or business partners.
Manage and perform claims review on claims assessors' cases as part of the claims authority upgrade process.
Manage and report on claims/compliance audits to ensure quality assessment and compliance is achieved and identify any improvement areas.
Perform regular review of underwriting guidelines to ensure relevance, competitiveness, and drive operational efficiency while maintaining good risk management and long-term sustainability of Portfolio.
Work closely with other departments and vendors in delivering robust Claims process flow.
Develop and maintain rules in the claims system for STP and identify opportunities that provide operational efficiency, support business growth and seamless customer experience.
Leverage internal & external data to understand current state, trends and opportunities in improvement/growth areas.
Support improvement in SLA and minimizing penders through identifying improvement opportunities, automation, streamlining processes & guidelines.
Support improvement in onboarding NPS through various initiatives, manage and monitor team performance in meeting departmental service expectations and deliver excellent service quality to customers.
Participate in Roadshows, Quality leaders meetings and focus group dialogues to gain insight and provide education on Medical Claims and FWA.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.
#J-18808-Ljbffr