Asst Manager, Customer Promise - Healthcare ClaimsThis is a 24/7 rotation shift schedule role.
Principal Duties & Responsibilities: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' enquiries from all sources of referrals are promptly attended to and resolved via appropriate communication mode.
To ensure and monitor claims processing benchmark and turnaround time.
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 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 compliance with Financial Services Act (FSA), Bank Negara Malaysia, Anti-Money Laundering & Counter-Financing of Terrorism (AML/CFT) efforts, LIAM guidelines, and internal guidelines as applicable.
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A rewarding and fulfilling career awaits you at Prudential. We believe in making a difference through the power of listening, striving to build brighter futures for our customers, employees, and society.
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