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Job Description

Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow and Succeed. Main responsibility remains to provide effective services in terms of Cashless Claims (24/7) for individual and group medical, customer service, problem solving, and complaint resolution and to deliver organization's capabilities to our valued customers and corporate clients Principle Duties & Responsibilities:
  • Main responsibility remains to provide effective services in terms of Cashless Claims (24/7) for individual and group medical, customer service, problem solving, and complaint resolution and to deliver organization's capabilities to our valued customers and corporate clients
  • Claims Management: Managing and analyzing health claims to determine extent of company’s liability, make approval or denial decisions and negotiate settlements with claimants in accordance with policy provisions
  • leading a big team of qualified insurance professionals (analysts and medical advisor) including Doctors, Pharmacists and nurses to do their operations jobs on day-to-day basis.
  • Leadership & Team management: Development and implement strategies, set operational goals, initiate measures to reach set goals so as to improve overall team performance.
  • Analyzed claim reports over software and check for the fraudulence if any and ensure required claims data and reports are accurate and complete for business reporting proposes (including TAT, SLA, CSAT, NPS, others)
  • Provider & Networking: Managing providers for various insurance companies, minimizing claims loss by efficient negotiation in terms of tariff, expansion of medical network providers across region.
  • Client Relationship Management: Maintaining cordial relations with customers to sustain the profitability of the business. Maximizing customer satisfaction level by on time delivery, monitoring customer complaints and providing efficient services. Ensuring quality delivery of services to the clients.
  • Underwriting & Risk Analysis: Deep and extensive experience in personal lines & medical underwriting, medical terminologies, as well as company procedures, policy provisions, compliance regulations and insurance law which support senior underwriters and financial analysts to figure out statistical evaluation of risk and assist in risk management.
  • Business development: Conducting competitor analysis by keeping abreast of market trends to achieve market share metrics. Acquiring new customers, providing services and enhancing existing relationships with customers.
  • Business Process Improvement: involve in project for preparation and implementation of process flows for better customer experience in cashless claim journey.

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 special requirements.

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Job Detail

  • Job Id
    929b1c4d3ba52afc
  • Location
    id
  • Company
  • Type
    Private
  • Employment Status
    Permanent
  • Positions
    Available
  • Career Level
    Experience
  • Gender
    Male/Female

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