Manager, Claims Manager, Claims …

Prudential
in Kuala Lumpur, Kuala Lumpur, Malaysia
Permanent, Full time
Last application, 03 Jul 20
Competitive
Prudential
in Kuala Lumpur, Kuala Lumpur, Malaysia
Permanent, Full time
Last application, 03 Jul 20
Competitive
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.

JOB SCOPE:
The incumbent is responsible to manage an efficient and effective Claims team by meeting and exceeding management's 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 customer's 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.

PRINCIPAL DUTIES & RESPONSIBILITIES:
  • Responsible for day to day operations, provide analysis on impact and act strategically in optimizing the operation capacity to meet the business goal set forth as the service standard level.
  • Analyze team productivity on daily and monthly basis. Review & reports with constructive feedback and action plans by identifying underlying course to improvements where appropriate.
  • Makes good & sound decision during uncertain and difficult context to minimize the disruption on operation and continuously review processes, identify and resolve service gaps through constructive feedback, and implement process improvements where appropriate.
  • Ensuring all claim examiners in the Claims ("type of Claims") Unit meets all type of service standards (benchmark and TAT) each month. Provide justification if not meeting the monthly service standard.
  • Analyze cause of problem affecting processing and recommend alternative solution.
  • Ensuring justifiable decision on claims made within a TAT set from date of notification.
  • To process claim with recommendation for settlement and approval within the department benchmark.
  • To handle queries from agents and insured and prospect customers via phone calls, letters, faxes and e-mails.
  • To correspondences on and day to day operation functions of the department and coordinates with other departments.
  • Claims appeal from insured and agent to be attended and respond within the benchmark set by the department.
  • Responsible in relation to customer's enquiry in order to maintain a high level of quality service to customer and record, produce and prepare any statistics and information required by the Management in relation to the customer enquiry and progress, inclusive of FMB & or BNM related to claims appeals / complaints.
  • To manage in coordinating and analyzed the clearance of outstanding cases.
  • Monitoring and analyzed the occurrences of incidences on the occurrences required with simple performance-based reports of individual staffs identified and log in the action plan, progress of the action taken inclusive monetary recovery and coverage based on ex-gratia on the occurrences filed.
  • Responsible for staff's development in training and re-training as and when required by identifying the base line of staff's assessment skills and the reports of occurrences in staff's assessment skills.
  • To conduct workshops with agency force in training technical understanding of product from the aspect of Claims ("subject to type of claims")


JOB REQUIREMENTS:
  • Degree in Biology/Biomedical Science/Business Administration/Mathematics/Economics/Statistics and/or a professional life insurance qualification .e.g. ACII, AMII, AAII, FLMI.
  • With Claims handling experience preferable 8 years in insurance industry / Life Insurance (preferable experience from "Major Claims type").
  • Knowledge on laws & regulations governing the insurance industry is highly essential.
  • Equipped with insurance knowledge & technical know-how on the fundamentals of Life Insurance, inclusive of Accidental & Medical business acumen (where appropriate / applicable to the respective incumbent)
  • Able to communicate & interact efficiently with internal & external customers.
  • Possess a good work ethic & professionalism is practiced in every single time.
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