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Prudential plc

Employee Benefits Claims

Prudential plc is hiring an Employee Benefits Claims. Level rates it ; you can apply on Prudential plc.

Level's read on this job

  • Level rates this role Little AI ●○○○: aI is not part of the work.
  • Level classes it as a mid-level role.
  • Prudential plc has 437 other open roles on Level.

AI in this role

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 will provide dedicated claims services to claimants and Financial Service Consultants by ensuring delivery of key service objectives through efficient and effective claims management.

Job Description: 

  • Adjudicate Group Major Claims (Death, TPD, Critical Illness, Disability, Terminal Illness, etc) and Group Medical Claims (Hospital & Surgical, Major Medical, Outpatient Specialist, Outpatient Clinical, Dental, etc) and ensure delivery of prudent and equitable claims decision within expected service level (i.e. claims turnaround time). 

  • Compliant with regulatory requirements, corporate guidelines, policy wording and reinsurance terms. 

  • Work closely with underwriters and other business units to ensure that claims are processed accurately and that all service level agreements are met. 

  • Manage working relation with external parties – Central Provident Fund Board (CPFB), medical institutions, TPAs, etc. 

  • Manage investigation of claims by working with claims adjusters, legal advisors, medical institutions, claimants, financial consultants, and other insurers to determine claims decision and payment. 

  • Manage enquiries, service recovery, complaints and appeal arising from claims. 

  • Follow up with claimants and medical institutions on any outstanding requirements required for claims adjudication through documented follow-up process and provide regular update on claims status. 

  • Any other ad-hoc assignment assigned.  

Who we are looking for: 

Competencies & Personal Traits 

 

  • Detail-oriented with a commitment to accuracy and quality.  

  • Innovative and resilient with a strong eye for detail 

  • Excellent communication skills in English, both written and verbal 

  • Conflict resolution and relationship management skills 

  • Customer-centric with ability to work under pressure 

  • Self-motivated and independent 

  • Team player 

 

Working Experience 

  • 2 to 3 years of working experience in both life and medical claims processing 

Education 

  • Diploma or Degree 

 

Language 

  • English 

 

 

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.

How we rate this

Employee Benefits Claims at Prudential plc rates 38 out of 100 for how much of the daily work is AI. That makes it Little AI (AI Level 1 of 4). The level is about AI in the job, not seniority.

Classification

Little AI. AI is not part of the work.

  1. ●●●● Builds AI80 to 100
  2. ●●●○ Works on AI60 to 79
  3. ●●○○ Uses AI40 to 59
  4. ●○○○ Little AI0 to 39

Levels come from how often the tools, models and workflows of the role are named in the posting itself. Read the description and count the AI tools, models and workflows it names.

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