PRUShield Claims recovery and PRUShield Policy Management are two main key initiatives for the Medical Portfolio Management team. Under PRUShield Claims recovery, our team assists customers in submitting claims to a third-party insurer. This role includes reaching out to customers when their PRUShield claims have been approved, follow up calls with customers and to assist customers with the collation of medical receipts and reports on behalf of the customer. The claims documentation and requirements are submitted to customer’s HR department or group insurer and the team will complete the process by following through with the group insurers.
The primary objective of this role is to assist customers and financial consultants with the recovery process. In addition, the specialist must create awareness of the benefits of submitting a recovery claim.
Under PRUShield Policy Management, you will perform a series of end-to-end policy transaction requests across the PRUShield Policy Management Team. The requests are Reinstatement, Upgrade, Downgrade, Conversion, Change of Payor, Termination, etc.
This is an exciting opportunity for those keen on taking on a new challenge that will have a direct positive impact to our organization's bottom-line.
Medical Services Specialist
- Reporting to Senior Shield Consultant, you will 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
PRUShield Recovery:
- Ensure SOP are followed when handling outbound and inbound calls to customers at all times.
- Daily reporting to PRUShield Recovery Team Lead on call activity and outcomes.
- Provide end to end support for each case handled.
- Ability to assist customers on their recovery claims process.
- Attend service and product trainings or any other trainings as and where required.
- Adhere to standard operating procedures for customer data privacy and protection (PDPA).
- Provide Team Lead with feedback from customers and financial consultants.
- Adhere to company’s code of conduct.
- Provide administrative support such as arranging courier, collecting courier, scanning and printing documents.
PRUShield Policy Management:
- Process Shield Policy transaction requests such as Reinstatement, Upgrade, Downgrade, Conversion, Change of Payor, Termination, etc, ensuring that TAT and Productivity KPIs are met
- Adhere to all SOPs, guidelines, PDPA, are met
- Ability to use SAP to reply to email enquiries from Call Centre
- Perform policy assessment whether the transaction requests can be processed. Ensure all checks are in place such as signatures, policy number, policyholder name, etc.
- Under the PRUShield products and CPF policy guidelines
You will be required to:
- Make 20-30 outbound calls daily
- Meet the set target for submission of claims to third party insurers
- Meet the set target for recovery payments received from third party insurers
- Attend to calls and emails pertaining to third party recovery within the agreed TATs
- Process between 10-15 PRUShield policy requests a day
Who we are looking for:
Competencies & Personal Traits
- Meticulous, able to process backend systems with accuracy
- A keen learner and able to work independently
- Friendly, proactive and service oriented individual with good interpersonal and communication skills
- Problem solving skills and a great team player who enjoys being in a target driven team
- Team player and enjoys interacting with customers
Working Experience
- At least two years’ experience in a customer service capacity or outbound/ in-bound call centre environment
- One to two years’ experience in integrated shield/ life insurance/ claims will be advantageous
Professional Qualifications
- Life insurance qualifications – Certificate in Life & Health Insurance will be an added advantage
- Proficient in MS Office such as Word and Excel
Education
- Poly diploma, GCE A level or relevant work experience
Language
- Strong command of the English language
Professional Qualifications
- • Life insurance qualifications – Certificate in Life & Health Insurance will be an added advantage
Education
- • Poly diploma, GCE A level or relevant work experience
Language
- • Strong command of the English language
