Manager, Customer Promise - Medical Reimbursement & Accident

Prudentials purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured for our people customers and partners. We provide a platform for our people to do their best work and make an impact to the business and we support our peoples career ambitions. We pledge to make Prudential a place where you can Connect Grow and Succeed.

JOB SCOPE:
The incumbent is responsible to manage an efficient and effective Claims team by meeting and exceeding managements expectations on operational processes. The complexity of the insurance business requires the incumbent to acquire a thorough knowledge of the different insurance products (and their functionalities / technicalities) and operational processes to ensure customers enquiries are resolved in accordance with agreed service levels. The incumbent is also required to work closely with other operations departments in delivering excellent service quality to customers.

Position Summary:
Claims Approval within authority limit
Claims Recommendation to the next Level
Planning overall strategy of the Unit
Managing the day to day functions of the Unit which include people system procedures and others.

PRINCIPAL DUTIES & RESPONSIBILITIES:
Appraising claims up to a company-specified approval limit.
Strategic planning managing coordinating controlling and monitoring the Unit plans to ensure that the operational objectives of the department and the company are being met.
Responsible in ensuring appropriate measures and controls on claims leakages and fraud management monitoring of legal cases are adhered to.
Assessing critical legal and industry issues on claims with high ambiguity and exposures to the company.
Ensuring that Insurance Act Bank Negara Malaysia Anti-Money Laundering & Counter-Financing of Terrorism (AML/CFT) efforts LIAM guidelines and internal guidelines are strictly complied with as applicable.
Applying complicated theory and fundamentals of claims appraisals.
Ensuring company-specific claims policy and guidelines are in line with Prudential Malaysia Claims policy and standards. This includes defining and implementing standards for accuracy productivity and timeliness as well as recommending strategies to meet those standards.
Reviewing and revising claims guidelines regularly to ensure that they are aligned with changes in the market legal and regulatory environments and product design.
Supervising the performance of subordinates.
Representing the department head in meetings.
Implementing projects for the streamlining of operations or improvement of servicing capabilities.
Determining appropriate training for subordinates to ensure that they are keeping up with market and business requirements.

REQUIREMENTS:

Education : Degree in Biology/Biomedical Science/Business Administration/Mathematics/Economics/
Statistics and/or a professional life insurance qualification .e.g. ACII AMII AAII FLMI etc..

Experience : 10 years of experience in claims including 5 years at a managerial level 5 years
in insurance claims administration and assessment (all claim types) and in-
depth knowledge of the insurance industry and Life/Group insurance claims.

KSAs : Well versed in Life/Group Products is a must.
: Knowledge on laws & regulations governing the insurance industry is highly essential.
: Equipped with insurance knowledge & technical know-how on the fundamentals of
Life Insurance.
: Able to communicate & interact efficiently with internal & external customers.
: Possess a good work ethic & professionalism is practiced in every single time.

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex race age ethnic origin educational social and cultural background marital status pregnancy and maternity religion or belief disability or part-time / fixed-term work or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.