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.

Job Purpose:

Oversee end-to-end claims management across multiple portfolios, ensuring timely, fair and compliant claims decisions while optimising cost efficiency and customer experience.

Key Accountabilities:

• Oversee inpatient/outpatient medical reimbursement, personal accident and allowance claims to ensure accurate and timely assessment based on certificate terms
• Manage high-value and complex claims (death, TPD, critical illness), ensuring consistent decisions aligned with underwriting intent, legal and Shariah requirements
• Oversee group and corporate claims including TPA management to ensure SLA fulfillment and effective performance monitoring
• Supervise cashless and non-cashless claims payments, ensuring efficient settlement, provider query resolution and payment accuracy
• Manage claim suspense accounts, unclaimed monies, and ensure strong financial controls and reconciliation accuracy
• Collaborate with cross-functional stakeholders and external partners to resolve complex claims cases
• Lead process improvement and system enhancement initiatives to optimise claims efficiency and digitalisation
• Lead, develop and mentor team leads and specialists, fostering a high-performance and customer-centric culture

Key Requirements:

• Bachelor’s degree in insurance, Business Administration, Medical Science, Actuarial Science, or a related field.
• Professional insurance certifications such as Fellow Life Management Institute (FLMI), Associate Insurance Institute (AII), or equivalent industry qualifications. Training in leadership, operational excellence, or process improvement methodologies (e.g Lean Six Sigma, project management) will be an added advantage.
• Minimum 10 years of experience in insurance/takaful claims management, preferably covering life, health, and group business portfolios with 3 years in a senior leadership or managerial role, overseeing multiple functional teams.
• Proven track record in managing diverse claims portfolios (medical reimbursement, accidental, death, TPD, critical illness, cashless/non-cashless payments, group/affinity claims; handling sensitive high value and complex claims with sound judgement; managing TPA performance, audit and SLAs; d) driving process improvement, digital transformation, and operational efficiency in claims.
• Experience working with cross-functional teams (e.g Underwriting, Risk, Compliance, Legal, Shariah, Customer Service, IT) and external stakeholders such as Re-takaful operators, corporate clients, and medical providers

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.