Executive, Customer Promise - Healthcare Claims

We are seeking an Executive, Customer Promise - Healthcare Claims to join our team in Kuala Lumpur. As an Executive, you will be responsible for providing efficient and effective support to meet and exceed customer expectations on operational processes.

Principal Duties & Responsibilities:

• Adhere to our claims workflow in relation to accident and hospitalization claims procedure
• Assess and provide justifiable claims according to policy terms and conditions to our valued policy holders
• Approve claims within the department benchmark/turnaround time and authority limit
• Recommend for claim approval/repudiation
• Ensure customers' enquiries from all sources of referrals are promptly attended and resolved via appropriate communication mode
• Monitor claims processing benchmark and turnaround time
• Correspond on day-to-day operation functions of the department and coordinate with other departments
• Handle incoming enquiries from internal or external parties via emails, phone calls, and faxes
• Update and submit 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 administrative rules and processes for effective and efficient operation of the sections
• Continuously attend/involve with training for personal and career development
• Undertake projects/other work and duties allocated by management as and when required