Head of Claims – Prudential BSN Takaful Berhad
Prudential’s 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 people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.
Key Responsibilities
Claims Operations
- Oversee the processing of medical and life insurance claims for individual policies and employee group benefits.
- Ensure productivity, timely and accurate processing of pay and file claims and cashless guarantee letter admissions.
- Develop and implement claims management strategies to improve efficiency and customer satisfaction.
- Develop and maintain staff rosters ensuring optimal coverage and compliance with labor laws.
- Conduct fraud investigations in a timely and thorough manner.
Team Leadership
Lead and manage the claims operations team, including claims processors, investigators, and support staff.Provide training, mentorship, and performance evaluations to team members.Foster a collaborative and high-performance work environment.Operational Excellence
Streamline claims processing workflows to enhance productivity and reduce turnaround times.Implement best practices and continuous improvement initiatives in claims operations.Monitor key performance indicators (KPIs) and ensure compliance with regulatory requirements.Customer Services
Ensure a customer‑centric approach in all claims handling processes.Address and resolve escalated claims issues and customer complaints.Collaborate with customer service teams to enhance the overall customer experience.Stakeholder Management
Collaborate with internal and external stakeholders, including underwriters, brokers, and healthcare providers.Maintain strong relationships with key partners to facilitate smooth claims processing.Represent the claims department in meetings and industry forums.Reporting & Analysis
Prepare and present regular reports on claims performance, trends, and areas for improvement.Utilize data analytics to drive decision‑making and strategic planning.Ensure accurate and timely reporting to senior management.Manage the claims budget and ensure cost‑effective operations.Lead project management activities such as system migration, product roll‑out and operations enhancements.Qualifications & Experience
Bachelor’s degree in Business Administration, Insurance / Takaful, or a related field.8‑10 years of experience in operations management, preferably in medical insurance operations, with 5‑10 years in a leadership role.In‑depth knowledge of medical and life insurance claims operations, including pay and file and cashless guarantee letter admissions.Strong leadership and team management skills.Excellent analytical and problem‑solving abilities.Exceptional communication and interpersonal skills.Proficiency in claims management software and data analytics tools.Experience in strategic planning and execution.A commitment to customer service excellence.Financial acumen.Knowledge of compliance and regulatory requirements.Project management experience preferred.Equal Opportunity Employment
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. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
Seniority level
ExecutiveEmployment type
Full‑timeJob function
Sales and Business Development#J-18808-Ljbffr