Claims Admin Officer (1 year contract)

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

Categorisation of claim documents, penders, appeals etc

2. Document Management & Verification

Reviewappealssubmittedto ensure relevant documents are complete for Claims Assessors

Liaise withFinancial Consultants,hospitals/ clinics and BDMsto obtain missing documentation

Ensure proper recording of claims assessments foraudit and compliancerequirements

3. Workflow Coordination

Assign and route claims to appropriate Claims Assessors based onrelevant tasks and complexity guidelines

Assist Team Lead to monitorandescalate ageing cases or bottlenecksand report backto 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 enquiriesescalated from Customer-fronting teams, or internal stakeholders regarding claim status

Escalate complex or sensitive cases to Claims Assessors orTeam Lead

Contact healthcare institutions if requirements are still pending for some time

5. System & Process Support

Update claims systems accurately, includingWorkbenchstatus, 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)

Experience 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 tomultitaskin 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 work discipline

Team player with willingness to support operational needs

Able to work under pressure and manage high claim volumes

Customer-focused mindset

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.