Medical Claims jobs

Job Profile Summary:
In this role, you will be part of the PruPanel Connect (PPC) programme to provide our customers with access to quality and affordable healthcare. The PPC provides a suite of value-added services (VAS) which include expedited appointment booking at our partner hospitals and their participating specialists, on site concierge services and complimentary transport/ carpark vouchers in the event of day surgery or admission to hospital. You will also assist customers and financial consultants with enquiries related to PRUShield including third party recovery of claims from group insurers. As part of this dynamic role, you will provide excellent customer service that has a direct positive impact to the bottom line of Prudential Singapore.

Job Description:
Concierge

• Provide on-site concierge services at private panel hospital.

• Collect the patient consent forms of customers who have been admitted to our partner hospitals.

• Contact customers who have consented to be contacted to offer assistance with claims and also issue complimentary taxi/ parking vouchers to customers who qualify and ensure adherence to SOP.

• Daily reporting to Medical Services Consultant on volume of walk-ins at concierge

Appointment Booking

• Provide appointment booking service at our panel specialists.

• Make follow up calls/ send emails to confirm appointments booked at our partner hospitals and their participating specialists.

• Adhere to standard operating procedures for customer data privacy and protection.

Third Party Claims Recovery

• Assist customers on their recovery claims process.

• Conduct daily outbound calls to customers and promote the benefits of a recovery claim.

• Achieve performance targets set; which include daily call productivity, contact rate, and success rate.

• Process end to end policy transaction requests in accordance to guidelines, service standard and quality.

• Perform policy assessment and judgment on policy changes.

• Follow up with customers on transaction requests.

• Provide support and services to Financial Consultants (FC) on Policy Servicing matters.

• Handle appeals and cases escalated from FC and customer complaints.

• Processing of data entry for recovery payments.

• Provide end to end support for each case handled.

• Attend service and product trainings or any other trainings as and when required.

• Provide Team Lead with feedback from customers and financial consultants.

• Adhere to company’s code of conduct.