Role Summary
This role involves reviewing and approving PruShield claims within turnaround times while ensuring strict compliance with internal policies. You will work closely with hospitals and clinics for medical clarifications and provide high-quality service to customers.
Job Description
The Associate Manager, Claims-1 is responsible for reviewing, assessing, and approving shield claims while adhering to service turnaround times. You will ensure all outputs are accurate and compliant with internal policies and regulatory standards. Key tasks include conducting claims investigations, service recovery, and medical clarifications with clinics and hospitals. Additionally, you will handle customer inquiries, manage complaints, and participate in special projects assigned by leadership to improve operational efficiency.
Job Requirements
Strong command of the English language, both spoken and written.
Deep familiarity with human anatomy, general diseases, and disease management.
Proven ability to review, assess, and approve claims accurately.
Experience in conducting medical clarifications with hospitals and clinics.
Strong customer service skills for handling inquiries and complaints.
Ability to manage service recovery and complex claims investigations.
Capacity to contribute to assigned projects and meet turnaround deadlines.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Skills Required
7 skills
Click to submit your application
Required Skills
Claims Assessment
Medical Knowledge
Customer Service
Claims Investigation
Regulatory Compliance
Service Recovery
English Communication
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