Senior Claims Examiner

2 days ago


Singapur, Singapore Prudential plc Full time

At Prudential, we're committed to being partners for every life and protectors for every future. Our purpose drives everything we do, creating a culture where diversity is celebrated and inclusion is assured. We provide a platform for our people to excel and make an impact, supporting their career ambitions.

Job Profile Summary:

In this role, you'll provide dedicated claims services to claimants and Financial Service Consultants, ensuring efficient and effective claims management. Your expertise will be crucial in delivering key service objectives and driving business success.

Key Responsibilities:

  • Adjudicate Shield and Accident & Health (A&H) claims, ensuring timely and equitable decisions.
  • Comply with regulatory requirements, corporate guidelines, policy wording, and reinsurance terms.
  • Review workflow and claims processes to identify areas for improvement and implement enhancements.
  • Collaborate with underwriters and other business units to ensure accurate claims processing and meet service level agreements.
  • Manage relationships with external parties, including Central Provident Fund Board (CPFB), regulators, financial consultants, and medical institutions.
  • Investigate claims, working with claims adjusters, legal advisors, medical institutions, claimants, and other insurers to determine claims decisions and payments.
  • Manage enquiries, service recovery, complaints, and appeals arising from claims.
  • Follow up with claimants and medical institutions on outstanding requirements, providing regular updates on claims status.

Requirements:

  • Strong command of the English language (spoken and written).
  • Familiarity with human anatomy, general diseases, and disease management.
  • 4-5 years of experience as a Life & Health claims assessor.
  • OMA, FLMI (Fellow, Life Management Institute) qualifications.
  • Degree holder in biology & life sciences discipline.
  • English language proficiency.


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