Senior Executive – Medical Officer

Senior Executive – Medical Officer

Prudential Financial, Inc
2-5 years
Not Specified

Job Description



At Prudential, we understand that success comes from the talent and commitment of our people. Together, we have a shared vision in securing the future of our customers and our communities. We strive to build a business that can shape, an inclusive workplace where ideas are valued and a culture where can thrive together. Our people stay connected and tuned in to what's happening around us, keeping us ahead of the curve. While focused on the long-term, we look to the future to bring growth, development and benefit to everyone whose lives we touch.This job holder will responsible for delivering prompt and accurate results in the areas of claim process, managing overall team.
Principle Dutiesand Responsibilities:
1. Claim Analyst
  • Analyze Hospitalization claim based on policy provision and
  • Medical necessity, including investigation to hospital and/or
  • Treating doctors, if needed
  • Prepare claim letter for claim paid and decline
  • Maintain and improvement service standard
  • Handling complain and error monitoring
  • Improvement of product and system knowledge

2. Medical Officer (CMO) :
  • As medical consultant for Claim Team specifically Claim Helpdesk Team and Claim Analyst.
  • Develop medical knowledge for Claim Analyst to be able to independently process claim
  • Handling Claim complex case

3. Personal development :
  • ALMI designation (LOMA) within 2 years
  • Attend training designed for Medical Officer Excellence Program

4. Being center of excellence:
  • Analyze current process and give suggestion for process improvement
  • Involve in project to improve current process
  • Centre of knowledge (give training)

5.Ensure smooth communication with other departments
  • Doing meeting with other departments as needed to solve Claims issues
  • In difficult cases where problems are unsolved by team, ensure quick and justifiable solution is given
  • Ensure customer orientation is the basis for every approach

6. Liaise with Legal & Compliance to report suspicious transactions that finding in doing daily process & Ad-hoc assignment
Job Requirements :
Qualification
  • Bachelor degree (Medical Doctor)
  • Fresh graduate or maximum 2 years in hospital
  • Strong analytical and inter-personal skill
  • Good problem solving skill
  • Having good sense of risk selection
  • Good communication skill
  • Pleasant personality, good attitude and good team working
  • Action-oriented and customer oriented
  • Good command in English
  • Computer literate : word, excel, visio and power point applications
  • Claim process, policy provision

Job Details

Prudentialplc provides life and health insurance and asset management, with a focus on Asia and Africa. We help people get the most out of life, by making healthcare affordable and accessible and by promoting financial inclusion. We protect people's wealth, help them grow their assets, and empower them to save for their goals. The business has more than 18 million life customers in Asia and Africa.Prudential has been providing trusted financial security for 95 years and is listed on stock exchanges in London, Hong Kong, Singapore, and New York. We are proud to be included in the 2022 Bloomberg Gender Equality Index. The index measures gender equality across five pillars: female leadership and talent pipeline, equal pay and gender pay parity, inclusive culture, sexual harassment policies, and pro-women brand. Our inclusion in this global index is testament to our commitment to nurturing diverse talent. #BloombergGEI . Prudential plc is not affiliated in any manner with Prudential Financial, Inc., a company whose principal place of business is in the United States of America or with the Prudential Assurance Company, a subsidiary of M&G plc, a company incorporated in the United Kingdom.

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