Role Summary
The Associate Manager, Claims is responsible for reviewing, assessing, and approving PruShield claims. This role plays a critical part in ensuring compliance with internal policies and regulatory standards while enhancing operational efficiency.
Job Description
As an Associate Manager for Claims, you will engage in daily activities that involve reviewing claims and communicating with medical facilities. You will work in a dynamic environment that requires collaboration with various stakeholders to ensure accurate and timely claims processing.
Key Responsibilities:
- Review and assess PruShield claims within established service turnaround times.
- Approve claims ensuring compliance with internal policies and regulatory standards.
- Conduct claims investigations to gather necessary information.
- Communicate with medical facilities for clarifications on claims.
- Handle customer inquiries and manage complaints effectively.
- Participate in special projects assigned by leadership to enhance operational efficiency.
- Ensure all outputs are accurate and meet quality standards.
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.
Quick Info
Company
—
Location
Kuala Lumpur
Salary
Undisclosed
Incentive / Bonus
Performance-based incentives as per company policy
Skills Required
7 skills
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Required Skills
Claims Assessment
Customer Service
Communication
Problem Solving
Attention To Detail
Collaboration
Regulatory Compliance
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