Executive, Claims

Prudential’s purpose is to be partners for every life and protectors for every future. We celebrate diversity and inclusion for our people, customers, and partners, and we support our people’s career ambitions.

Job Description Summary

ROLE PURPOSE

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

ROLE DUTIES & RESPONSIBILITIES

This Role Is Accountable And Responsible For The Following

• Adjudicate Accident & Health (A&H) claims and ensure delivery of prudent and equitable claims decisions within the expected service level.
• Ensure compliance with regulatory requirements, corporate guidelines, policy wording and reinsurance terms.
• Manage claims investigation by working with claimants, financial consultants, medical institutions, insurers, and others to determine claims decisions and payments.
• Follow up on outstanding requirements needed for claims adjudication through a documented follow-up process and provide regular updates on claims status.
• Work closely with other business units to ensure that claims are processed accurately and that all service level agreements are met.
• Manage enquiries and appeals arising from claims.
• Support the team in implementing system enhancements or projects, translating business requirements into test scenarios and performing user acceptance testing.

Key Performance Indicators

Improving the customer’s instant experiences on claims by :

Additional Job Description

Competencies & Personal Traits

Working Experience

Language

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.

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