Health Services Specialist (1 year contract)

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.

PRUShield Claims recovery is a core initiative under the Medical Portfolio Management team designed to help customers submit claims to third-party insurers.

As a Medical Services Specialist within the Medical Portfolio Management team you will be responsible for supporting customers and financial consultants through the PRUShield Claims Recovery process. This involves guiding customers in submitting claims to third-party insurers by initiating 2-way SMS outreach conducting follow-up calls and assisting in the collation and submission of medical documentation to HR departments and group insurers. You will also promote awareness of recovery claim benefits and ensure a smooth end-to-end experience for all stakeholders. The role demands strong communication skills attention to detail and a commitment to achieving daily performance targets such as call productivity contact rate and claim success rate. Reporting to the Medical Services Consultant you will contribute directly to improving customer satisfaction and enhancing operational efficiency.

Job Description:

• Third Party Recovery
  • Conduct daily outbound calls to customers to raise awareness and promote the benefits of submitting a recovery claim.
  • Adhere strictly to customer data protection protocols including Personal Data Protection Act (PDPA) requirements during all inbound and outbound interactions.
  • Guide and assist customers throughout the recovery claims process addressing queries and offering support with documentation and submission. Provide end-to-end case management for each assigned customer ensuring smooth progression from initial contact to final resolution.
  • Ensure all assigned call leads are acted upon promptly and effectively with no lead left unutilized or wasted.
  • Perform administrative tasks such as arranging courier handling of medical reports scanning and printing documents to support claim submissions. Conduct follow-ups after claim submissions to confirm successful processing and address any outstanding issues.
  • Participate in ongoing service briefings product trainings and technical workshops as required to stay updated on product/regulatory changes.

• Third Party Recovery Mailbox
  • Respond to customer enquiry in a timely and accurate way via email.
  • Identify customer needs and assist customers use specific features of our online portal and website.
  • Analyse and report any red flag to team lead.
  • Produce a structured and professional replies considering the tone timing and presentation of your replies so that they are effective and respectful.
  • Address customer enquiries clearly and appropriately.
  • Resolve email enquiries within the Service Level Agreement (SLA).
  • Categorise email enquiries type and status via SAP.

• Third Party Recovery Hotline
  • Answering incoming calls from internal and external customers and Financial Consultants addressing inquiries resolving issues and documenting interactions in Life Asia system.
  • Possess strong communication active listening and problem-solving skills as well as the ability to work with various software systems and online portals.
  • Aspire to provide a one-call resolution experience to internal and external customers and Financial Consultations.
  • Takes ownership of the enquiry and if required provide follow up to ensure proper closure to the enquiry.
  • Collaborating with team members and other departments to achieve our customer centricity goal and improve customer experience.

• Support for Concierge Duties
  • Verify the customer data from internal working files (Patient Consent forms) submitted by concierge teams in the partner hospitals.
  • Verify and assess customers eligibility and qualification for transport voucher issuance in accordance with the applicable eligibility guidelines.
  • Cross-reference and match customer email addresses against internal databases to ensure accuracy.
  • Contact customers directly to verify and update their email addresses if discrepancies are found.

• Specialist Appointment booking
  • Receive and manage appointment booking requests submitted through the SAP Platform.
  • Contact customers within 2 hours of receiving the request to verify appointment details including preferred panel specialists clinic location and other relevant information.
  • Advise customers on applicable panel benefits to support informed decision-making.
  • Coordinate with partner healthcare institutions or specialist clinics to secure an appointment within 3 working days on a best-effort basis.
  • Follow up with customers via phone or email to confirm final appointment details and ensure a seamless booking experience.
  • Maintain accurate records of communications and booking status in internal systems.
  • Escalate any unresolved or urgent booking issues to the relevant internal teams as required.

Who we are looking for:

Skills & Competencies:

• Friendly proactive and service oriented individual.
• Team player and enjoys being in a target driven team.
• Two years experience with outbound or in-bound call centre environment.
• One to two years experience in integrated shield or life insurance preferred.
• Poly diploma GCE A level or relevant work experience.
• Life insurance qualifications Certificate in Life & Health Insurance.

Education & Experience:

• Diploma or bachelors degree in healthcare administration business or a related field
• 3 5 years of experience in customer service
• Experience handling provider enquiries contracts and agency relationships is preferred
• M5 M9 and HI qualifications would be advantageous

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.