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.
In this role, you are key to working very closely with the Team Lead and claims assessors to ensure claims are reviewed within the contractual boundaries swiftly. Pending requirements are handled responsibly within the SLA provided by the Team Lead.As part of this dynamic role, you will work closely with various Claims Assessors within the team, and connecting with other stakeholders, eg. healthcare institutions, Financial Consultants, Business Development Managers (BDMs), Customer-fronting teams, Policy Servicing and Underwriting teams to get things done.
The role focuses on handling tasks outside of the approval process, enabling Claims Assessors to prioritize adjudication, while ensuring compliance with internal SOPs and regulatory requirements and within the stipulated turnaround time.
You must be diligent and meticulous in ensuring proper documentation and completeness checks before routing the follow ups, eg. approval to Claims Assessors.
Key Responsibilities:
1. Claims Administration Support
Perform end-to-end administrative tasks for inpatient claims processing, including:
Registration and logging of incoming claims (data entry) with high accuracy
Processing of straight-forward claims which require human intervention
Categorisation of claim documents, penders, appeals etc
2. Document Management & Verification
Review appeals submitted to ensure relevant documents are complete for Claims Assessors
Liaise with Financial Consultants, hospitals/ clinics and BDMs to obtain missing documentation
Ensure proper recording of claims assessments for audit and compliance requirements
3. Workflow Coordination
Assign and route claims to appropriate Claims Assessors based on relevant tasks and complexity guidelines
Assist Team Lead to monitor and escalate ageing cases or bottlenecks and report back to Team Lead
Monitor claims that are pending return of Counter-offer Letter (revised terms)
Support backlog management and turnaround time (TAT) targets
4. Customer & Stakeholder Communication
Handle basic enquiries escalated from Customer-fronting teams, or internal stakeholders regarding claim status
Escalate complex or sensitive cases to Claims Assessors or Team Lead
Contact healthcare institutions if requirements are still pending for some time
5. System & Process Support
Update claims systems accurately, including Workbench status, Claims Notes, Policy Notes
6. Compliance & Quality Assurance
Adhere strictly to internal SOPs, audit requirements, and regulatory guidelines (e.g., MOH, where applicable)
Ensure data confidentiality and proper handling of sensitive medical information
Who Are We Looking For:
Qualifications & Experience
Diploma or Degree in any discipline (Healthcare, Business, or Administration preferred)
Experience in claims processing, healthcare administration, or insurance operations is an advantage
Fresh graduates with strong administrative skills may be considered
Skills & Competencies
Strong attention to detail and accuracy (meticulous)
Able to multitask in a fast-paced environment
Able work under pressure and fulfil last minute tasks assigned within tight timeline and manage high claim volumes
Good communication and interpersonal skills
Proficient in Microsoft Office (Excel, Word) and claims systems (preferred)
Responsible and reliable with strong work discipline
Team player with willingness to support operational needs
Able to work under pressure and manage high claim volumes
Customer-focused mindset
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.