Employee Benefits Claims

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

In this role, 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.

Job Description:

• Adjudicate Group Major Claims (Death, TPD, Critical Illness, Disability, Terminal Illness, etc.) and Group Medical Claims (Hospital & Surgical, Major Medical, Outpatient Specialist, Outpatient Clinical, Dental, etc.) 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.
• Collaborate with underwriters and other business units to ensure accurate claims processing and meet service level agreements.
• Manage working relationships with external parties, including Central Provident Fund Board (CPFB), medical institutions, TPAs, etc.
• Investigate claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decisions and payments.
• Handle enquiries, service recovery, complaints, and appeals arising from claims.
• Follow up with claimants and medical institutions on outstanding requirements for claims adjudication through a documented follow-up process and provide regular updates on claims status.
• Perform any other ad-hoc assignments as needed.

Who we are looking for:

• Detail-oriented with a commitment to accuracy and quality.
• Innovative and resilient with a strong eye for detail.
• Excellent communication skills in English, both written and verbal.
• Conflict resolution and relationship management skills.
• Customer-centric with the ability to work under pressure.
• Self-motivated and independent.
• Team player.

Working Experience:

• 2 to 3 years of working experience in both life and medical claims processing.

Education:

• Diploma or Degree.

Language:

• English.