Senior Manager/ Manager, Claims Senior Manager/ Manager, Claims …

Prudential Hong Kong Limited
in Hong Kong, Hong Kong, Hong Kong
Permanent, Full time
Be the first to apply
Prudential Hong Kong Limited
in Hong Kong, Hong Kong, Hong Kong
Permanent, Full time
Be the first to apply
Senior Manager/ Manager, Claims
At Prudential, we understand that success comes from the talent and commitment of our people. Together, we have a shared vision in securing the future of our customers and our communities. We strive to build a business that you can shape, an inclusive workplace where everyone's ideas are valued and a culture where we can thrive together. Our people stay connected and tuned in to what's happening around us, keeping us ahead of the curve. While focused on the long-term, we look to the future to bring growth, development and benefit to everyone whose lives we touch.

The incumbent is responsible for overseeing the operations of claim cases. Primary job focus on claims escalated cases from teammates, supporting the handling of complaints from regulatory bodies and customers, take part in the monthly Independent Quality Control (IQC) exercise and providing effective suggestions to the claims assessors in relation to the quality of the claims assessment.

Job Responsibilities:

  • Manage and oversee the operations of claims to meet operations, productivity, quality & control and services requirements
  • Establish proper procedures and policies to be utilized throughout the life cycle of claims process
  • To be responsible for strategic processing and payment / approval of pre-authorisation cases and claims
  • Identify employee and team objectives, manage associated plans and provide guidance to subordinates in claims
  • Ensure the turnaround time of claims are met
  • Ensure the claims guidelines are properly followed in compliance with the company
  • Approve escalated claim from teammates when necessary
  • Approve claims within own claims authority and able to make solid recommendation to senior manager for other exceptional claims
  • Handle enquiries and complaints from customers, distributors, servicing provider, internal staff and media including but not limited to Insurance Authority (IA), Independent Complaint Bureau (ICB), Consumer Council
  • Responsible for monthly IQC and provide professional advice to the assessment teams to enhance the quality of work
  • Review management reports and implement corrective actions identified
  • Prepare for and participate in audits and compliance review and ensure the operations procedure is in compliant to the set rules and regulations
  • Maintain open communication channel with other departments and management, including but not limited to Underwriting, Finance, People and IT teams

Job Requirements:

  • Bachelor degree or qualifications in medical professional
  • Minimum 10 years' solid experience and 7 years in leading people in claims or pre-authorization functions
  • Strong customer centricity and willing to go extra miles to help the internal and external customers Multi-tasking, with strong sense for looking at innovative means to improve operations efficiency and customer experience
  • Strong collaboration, time management
  • Excellent communication skills and change management skills
  • Be proactive, with strong sense of responsibility, ability to multi-task
  • Ability to multi-task, strong organizational and problem- solving skills
  • Excellent verbal and written communication skills in English and Chinese
  • Familiar with MS Office and Chinese typing