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.
Responsibilities:
- As the assistant manager, this role has to lead and develop the Cashless Claims team to achieve service and operational targets.
- Ensure cashless claim processes are delivered accurately and within agreed SLAs.
- Provide guidance on policy interpretation and complex claim cases.
- Coach and support team members through regular feedback, training, and case discussions.
- Manage team capacity, shift planning, and attendance to ensure smooth operations.
- Monitor service quality and compliance with internal policies and procedures.
- Oversee workload distribution and team productivity.
- Handle escalated cases and support issue resolution.
- Review operational performance and provide regular management reports.
- Build strong relationships with healthcare providers, customers, and internal stakeholders.
- Approve claim-related requests within delegated authority limits.
- Ensure all communications are handled professionally and aligned with service standards.
- Drive process improvements to enhance efficiency and customer experience.
Requirements:
- Bachelor's Degree (S1) in Public Health, Nursing, Pharmacy, Dentistry, or other relevant Health Sciences disciplines.
- Minimum 5 years of working experience in healthcare, insurance, or managed care operations and team leadership experience.
- Hands-on experience in Pre-Authorization, Discharge Planning, Case Monitoring, Guarantee Issuance, and Cashless Claims Operations.
- Strong understanding of medical insurance principles, policy provisions, healthcare practices, and cashless claims processes.
- Good understanding of provider network management, medical terminology, and healthcare service delivery.
- Familiar with customer service standards, operational risk management, quality assurance, and service level agreement (SLA) management.
- Proficient in analyzing and implementing process improvement initiatives.
- Willing to work in shifting arrangements.
Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organization 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.
