# Executive, Claims

**Company**: Prudential
**Location**: Kuala Lumpur, PSA PACS
**Experience**: executive
**Job type**: full-time
**Category**: Finance
**Industry**: Finance

**Apply**: https://prudential.wd3.myworkdayjobs.com/en-US/prudential/job/Kuala-Lumpur-PSA-PACS/Executive--Claims_25090391-4?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_7b4d729e-4b9

## Description

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

ROLE PURPOSE: 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: This role is accountable and responsible for the following:

- Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decision within expected service level.

- Ensure compliance with regulatory requirements, corporate guidelines, policy wording, and reinsurance terms.

- Manage claims investigation by working with claimants, financial consultants, medical institutions, insurers, etc. to determine claims decision and payment.

- Follow up on outstanding requirements needed for claims adjudication through documented follow-up process and provide regular update 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.

- Support the team in implementing system enhancements or projects.

KEY PERFORMANCE INDICATORS: Improving the customer's Instant experiences on claims by:

- Ensuring that the claims are processed within the expected service level;

- Attaining the benchmarked targets for productivity, claims pending rate, suspense management rate

COMPETENCIES & PERSONAL TRAITS:

- Excellent communication, interpersonal, and problem-solving skills with ability to investigate, evaluate, and reach an appropriate decision

- Customer-centric with ability to work under pressure

- Self-motivated and able to work independently

- Team player, mature, with excellent leadership quality.

- Good medical knowledge and claims settlement procedure.

- Ability to read basic Chinese will be advantageous

## Skills

### Required
- claims management
- regulatory compliance
- communication
- problem-solving
- leadership

### Nice to have
- medical knowledge
- Chinese language

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Source: [Apply at prudential.wd3.myworkdayjobs.com](https://prudential.wd3.myworkdayjobs.com/en-US/prudential/job/Kuala-Lumpur-PSA-PACS/Executive--Claims_25090391-4?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)