Process Improvement and Transformation Specialist
12 hours ago
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.
This role reports directly to the Lead, Process Improvement and Transformation and will be working closely with PRUShield claims user on escalated issues to provide interim solution and support for the division.The incumbent will work under the direction of the Lead, Process Improvement and Transformation, the individual will be the initial point of contact for claims users and will need to collaborate with each users directly on escalated issues. The individual will also be providing support to ensure systems information/data are updated on a timely manner. The role requires a close attention to detail and able to work closely with claims assessor.
Job Descriptions
- Review all system related feedback/escalation, from claim assessors and servicing team.
- Work with tech team/Business Analyst to investigate on issue.
- Collaborate with tech team to identify interim solution and permanent solution.
- Raise Remedy Force ticket and monitor all outstanding tickets.
- Prepare necessary forms for table lifting and DFU.
- Monitor and track all open DFU/Table Lifting with proper record of all DFU performed by PRUShield claims team.
- Coordinate with claim assessors and tech teams on DFU process.
- Review and sign off when DFU is completed.
- Work with tech team on regular table lifting (daily)
- Review and ensure process is completed before providing sign off when table lifting is completed
- Maintain of data in LifeAsia/Jireh system - panel/non-panel/Extended panel list
- Ensure timely updates of data provided by MOH in system – Clinics, Cancer Drug List, TOSP/ICD Codes
- Identify opportunities for the prevention of Fraud, Waste and Abuse (FWA) within Prushield Claims to control the financial and reputational risk
- Translate FWA business logics into system rules and work with the relevant stakeholders for the deployment of the rules in the production system
- Collaborate with the QA Tester to ensure and validate the accuracy of the test results in the UAT environment prior to the deployment in the production
Who we are looking for
Competencies & Personal Traits
- System related knowledge is an advantage
- Able to work closely with different team
- Ability to work in a fast pace environment with tight deadlines
Working Experience
- Minimum 2-3 years of experience, a must to have experience in health/shield claims
Education
- Bachelor's Degree
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.
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