Claims Admin Officer (1 year contract)

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   C ategorisation 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 a nd complexity guidelines   Assist Team Lead to m onitor   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)   E xperience 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