# Head of Claims

**Company**: Prudential
**Location**: Kuala Lumpur
**Experience**: senior
**Job type**: full-time
**Category**: Operations
**Industry**: Finance

**Apply**: https://prudential.wd3.myworkdayjobs.com/en-US/prudential/job/Kuala-Lumpur-Takaful/PBTB---Head-of-Claims_26080115?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_881cec7f-e67

## Description

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

The Head of Claims is responsible for providing leadership to the end-to-end claims process for both individual policies and employee group benefit claims.

**Job Description:**

### Claims Operations

- Oversee the processing of medical and life insurance claims for individual policies and employee group benefits.

- Ensure productive, timely, and accurate processing of pay and file claims and cashless guarantee letter admissions.

- Develop and implement claims management strategies to improve efficiency and customer satisfaction.

- Develop and maintain staff rosters ensuring optimal coverage and compliance with labor laws.

- Conduct fraud investigations in a timely manner.

### Team Leadership

- Lead and manage the claims operations team, including claims processors, investigators, and support staff.

- Provide training, mentorship, and performance evaluations to team members.

- Foster a collaborative and high-performance work environment.

### Operational Excellence

- Streamline claims processing workflows to enhance productivity and reduce turnaround times.

- Implement best practices and continuous improvement initiatives in claims operations.

- Monitor key performance indicators (KPIs) and ensure compliance with regulatory requirements.

### Customer Services

- Ensure a customer-centric approach in all claims handling processes.

- Address and resolve escalated claims issues and customer complaints.

- Collaborate with customer service teams to enhance the overall customer experience.

### Stakeholder Management

- Collaborate with internal and external stakeholders, including underwriters, brokers, and healthcare providers.

- Maintain strong relationships with key partners to facilitate smooth claims processing.

- Represent the claims department in meetings and industry forums.

### Reporting and Analysis

- Prepare and present regular reports on claims performance, trends, and areas for improvement.

- Utilize data analytics to drive decision-making and strategic planning.

- Ensure accurate and timely reporting to senior management.

- Manage the claims budget and ensure cost-effective operations.

### Project Management

- Ensure smooth system migration for product rollout, timely UAT, and operations enhancement.

**Qualification and Experience:**

- Bachelor's degree in Business Administration, Insurance/Takaful, or a related field.

- A minimum of 8-10 years of experience in operation management, preferably in medical insurance operations, with at least 5-10 years in a leadership role.

- In-depth knowledge of medical and life insurance claims operations.

- Strong leadership and team management skills.

- Excellent analytical and problem-solving abilities.

- Exceptional communication and interpersonal skills.

- Proficiency in claims management software and data analytics tools.

- Experience in strategic planning and execution.

- A commitment to customer service excellence.

- Financial acumen.

- Knowledge of compliance and regulatory requirements.

## Skills

### Required
- claims management
- leadership
- team management
- analytical skills
- problem-solving
- communication
- interpersonal skills
- data analytics
- strategic planning
- project management
- compliance
- regulatory requirements

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Source: [Apply at prudential.wd3.myworkdayjobs.com](https://prudential.wd3.myworkdayjobs.com/en-US/prudential/job/Kuala-Lumpur-Takaful/PBTB---Head-of-Claims_26080115?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)