Role Summary
Responsible for the assessment and approval of PruShield claims, ensuring compliance and accuracy. This role involves stakeholder interaction, medical clarification, and high-quality customer service within a dynamic claims team.
Job Description
As an Associate Manager for Claims, you will be responsible for reviewing, assessing, and approving PruShield claims within established service turnaround times. You will ensure all outputs are accurate and compliant with internal policies and regulatory standards. Key duties include conducting claims investigations, service recovery, and communicating with medical facilities for clarifications. You will also handle customer inquiries, manage complaints, and participate in special projects as assigned by leadership to enhance operational efficiency.
Job Requirements
Strong command of the English language (spoken and written).
In-depth familiarity with human anatomy and general diseases.
Solid understanding of disease management protocols.
Previous experience in claims assessment and approval processes.
Ability to handle service recovery and complex customer inquiries effectively.
Capacity to work collaboratively with hospitals and clinics for medical clarifications.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Skills Required
8 skills
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Required Skills
Claims Assessment
Claims Investigation
Customer Service
Medical Knowledge
English Communication
Regulatory Compliance
Service Recovery
Project Management
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