Senior Executive, Claims

Prudential's purpose is to be partners for every life and protectors for every future.

As a Senior Executive, Claims, you will provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management.

Role Duties & Responsibilities:

• Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decisions within expected service levels.
• Ensure compliance with regulatory requirements, corporate guidelines, policy wording, and reinsurance terms.
• Manage claims investigations by working with claimants, financial consultants, medical institutions, insurers, etc. to determine claims decisions and payments.
• Follow up on outstanding requirements needed for claims adjudication through documented follow-up processes and provide regular updates on claims status.
• Work closely with other business units to ensure that claims are processed accurately and that all service level agreements are met.
• Manage enquiries and appeals arising from claims.

Key Performance Indicators:

• Improving the customer's instant experiences on claims by:
• Ensuring that claims are processed within the expected service level;
• Attaining benchmarked targets for productivity, claims pending rate, suspense management rate.

Competencies & Personal Traits:

• Excellent communication, interpersonal, and problem-solving skills with the ability to investigate, evaluate, and reach an appropriate decision.
• Customer-centric with the ability to work under pressure.
• Self-motivated and able to work independently.
• Team player, mature, with excellent leadership qualities.
• Good medical knowledge and claims settlement procedures.
• Ability to read basic Chinese will be advantageous.

Working Experience:

• At least 1-2 years of experience as a Life & Health claims assessor.

Language:

• Strong command of English language.
• Basic Chinese will be advantageous.