Senior Claims Assessor

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 included assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact on the business, and we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Job Purpose / Position Objective

This role is to:

. Assess claim documents based on the claimant's requirements and

. Identify and detect signs of abuse/fraud cases and escalate to higher levels as necessary

This position helps:

. Appraise and evaluate compensation documents based on the customer's request to resolve insurance benefits and

. Detect and prevent situations showing signs of fraud, abuse and fraud in life insurance to report to superiors

Job Responsibilities / Scope of work

- Make decisions on the claim cases quickly and exactly based on T&C

(Make decisions to assess compensation documents quickly and accurately according to each Product Terms)

- Act as a sign-off person and a mentor role: Countersign for claim assessor, trainee claim assessor within own authority and on-

the-job training new claim assessors and jet claim assessors

(Play the role of professional guidance and expertise and make the final decision in cases requiring opinions from a higher

level of claims adjuster within the scope of authority, participate in training claims adjuster within their capacity

authority, participate in practical guidance for new adjuster and qualified adjuster

from other medical and pharmaceutical specialties)

- Assist Claims Assessment Manager in developing the Operating Manual, Internal guidelines to enhance the efficiency and

effectiveness of the assessment process.

(Support Management of Compensation Appraisal Services to develop Operational Manual, Operational Guidance Procedures) Ministry to improve

and perfect the process)

- Participate in projects related claim transformation/claim automation/claim system enhancement to align with claim strategies

and improve customer experience collaborate in the development of new products related to claim process.

(Participate in projects oriented towards automation, digitalization and process improvement to align with the company's operating strategy

and improve experience Experience Customers participating in the development of new products related to the claims process)

- Support CCR/Agents/Customer during Claims Care process to explain claim decisions on order to enhance customer experience

and reduce claim complaints.

(Support related teams CCR/Agents/TVV/Customer through the Claim Care process to explain claim decisions to

enhance Customer experience and reduce Customer complaint rate)

- Support claim colleagues (investigators or administrators) in specific situations (including reading original medical record at the

hospital, conducting field assessment of disability, advising administrators…) Support underwriting section during period of

increased volume of NBUW (month-end, contest…), if necessary.

(Support colleagues: support investigators and claim reception specialists in each specific case (read original cases at the hospital, evaluate injuries at home, provide professional guidance to specialists receiving compensation claims, etc.) Support the Appraisal Department and issue contracts when the volume of documents increases at the end of the month, the end of the year, etc.) - Co-operate with claim Investigator in interviewing customers/claimants in specific situations develop internal guidelines and claim guides. (Coordinate with compensation investigation specialists in cases of collecting additional information from customers or compensation claimants and contributing constructive comments and editing the department's Operations Manual and internal process instructions to continuously improve.) - Perform other tasks to be assigned by the line manager or Company's management (if any) (Perform other tasks when requested by leaders director)

Job Requirements / Job requirements

Qualifications / Degree

- Mandatory: University graduated in Economics, Business, (University graduate:: economics, business,...)

- Advantage: Medical/ pharmaceutical (Graduate in medicine/pharmacy is an advantage)

Experiences/ Experience:

- Mandatory: at least 3 years of experience in the insurance industry or hospital (At least 03 years of experience in the insurance industry or hospital)

- Advantage: work at the hospital and life insurance (Priority for experience working in the hospital or life insurance)

Knowledge and skill set (English: at least reading and writing, speaking good English is an advantage)

- Microsoft office: word, excel, powerpoint (Office computer)

- Good communication skills, Problem solving skills, telephone skills and teamwork Leadership: basic level according to PVA's leadership behavioral competency framework)

Core Values

. Our Customer is our Compass We respect and care for each other

. We Deliver on Our Commitments / We fulfill our commitments

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organization regardless of sex, race, age, ethnic origin, education, 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.