Job Description

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.

In this role, you will lead and manage the Enterprise Business Claims team in delivering high-quality services and ensuring timely and accurate claim assessments and settlements. This role requires strong operational skills, effective communication, and a keen eye for detail.

· To lead and mentor the Enterprise Business Claims team, ensuring timely and accurate claim assessments and settlements.

· Provide guidance and support to team members to ensure smooth daily operations.

· 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 (i.e. claims turnaround time).

· 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.

Who we are looking for:

Competencies & Personal Traits

· Detail-oriented with a commitment to accuracy and quality.

· Innovative and resilient with a strong eye for detail

· Excellent communication skills in English, both written and verbal.

· Strong problem-solving and decision-making abilities.

· Ability to work collaboratively in a team-oriented environment.

· Ability to manage multiple priorities in a fast-paced environment.

Working Experience

· 5 to 7 years of experience in Life and Medical claims handling with insurers or insurance related industry

· Knowledge of Employee Benefit medical insurance is a must.

· Previous supervisory experience is a plus.

Education

· Diploma or Degree

Language

· English

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.