Claims Service Senior Specialist

3 days ago


Ho Chi Minh City, Vietnam Prudential plc Full time

Prudential's purpose is to help people get the most out of life. We will deliver our purpose by creating a culture in which diversity is celebrated and inclusion assured, for our colleagues, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and in exchange, we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow and Succeed.

This role is to ensure that the claim case was processed met to standard TAT. Support Customer Service, Call Center & Sales channels to handle claim issue. Contact closely with IT, Actuary, Product to set up automation tool on claim system

Xử lí kết quả yêu cầu bồi thường bảo hiểm của Khách hàng nhanh chóng, chính xác. Kết hợp cùng các đồng nghiệp và phòng ban liên quan để cung cấp dịch vụ bồi thường bảo hiểm hoàn hảo. Cùng IT và các phòng ban liên quan xây dựng hệ thống giúp tự động hóa các nghiệp vụ

Job Responsibilities:

- Scope 1: Manage all frontline activity / _Kiểm soát/ Xử lý các các hoạt động hằng ngày của Frontline

)
- _ Call/ Chat on Teams (via call/ chat on Microsoft Teams)_
- _ ZALO (via zalo number)_
- _
- Scope of the content related to / _
- Phạm vi nội dung phản hồi liên quan đến_
- Claim querry / _Giải đáp thắc mắc về tiến trình bồi thường_
- Update the process of processing claims to relevant departments
- Cập nhật tiến trình xử lí các yêu cầu bồi thường đến các phòng ban liên quan_
- _ Complaint handling_: Complaints involving Claims decisions,social media complaints: handled by Medical Service Senior Specialist (4A), working closely with Assessors and departmental representatives to provide information accurate information, support Complaint Handling related issues_
- Khiếu nại phức tạp: liên quan đến quyết định thẩm định, khiếu nại truyền thông, mạng xã hội: xử lý bởi _
- Medical Service Senior Specialist (4A), làm việc chặt chẽ với Thẩm định viên và đại diện phòng ban để cung cấp thông tin chính xác, hỗ trợ BP Giải quyết khiếu nại các vấn đề liên quan_
- Scope 2: Approval claim case / _
- Hoàn tất yêu cầu bồi thường sau khi nhận quyết định từ Thẩm định viên_
- Approval authority limit: 500M for job code 4A - Claims Service Senior Specialist (4A)
- Quyền phê duyệt các hồ sơ có hạn mức chi trả dưới 500tr: xử lý bởi chuyên viên cấp cao 4A_
- Complete the process to close a case by completing the steps of drafting the letter and payment values / _Hoàn tất quy trình thanh toán của 1 hồ sơ: soạn thảo thư báo và đảm bảo các giá trị chi trả_

Scope 3: Handling transactions related to payments from Claims, ensuring that the Contract is paid correctly and in sufficient amount, the remaining amounts that are not within the scope of payment need to be checked and handled in a timely manner /
_Xử lý các giao dịch liên quan đến các khoản chi trả từ Claims, đảm bảo Hợp đồng chi đúng và đủ số tiền, những khoản tiền còn lại không thuộc phạm vi chi trả cần được kiểm tra và xử lý kịp thời_

Scope 4: Other tasks when assigned /
_Các công việc khác khi được phân công_
- Willing to join the company's project with roles such as tester (Tester), Claims representative (Coordinator), claim (Requester)
- Sẵn sàng tham gia dự án của công ty với trò thử nghiệm (Tester), đại diện Claims (Coordinator), yêu cầu (Requester)_

Training & sharing claim knowledge /
_Chia sẻ kiến thức chuyên môn & huấn luyện các nghiệp vụ cơ bản cho các bộ phận tiếp xúc trực tiếp Khách hàng_

Job Requirements:
**Qualifications**:
_/ Bằng cấp_
- Graduated from university of Economics/ Finance & Accounting/ Information Technology
- Tốt nghiệp đại học Kinh tế hoặc Tài chính Kế toán hoặc Công nghệ thông tin_

Knowledge and skill / Kiến thức và kỹ năng
- MS Office: Excel, Word, Power Point / _Thông thạo phần mềm văn phòng_
- Fluency in English: at least reading & writing skill / _Anh văn lưu loát_
- Having knowledge of Insurance/ Law/ Medical is an advantage / _Ưu tiên có kiến thức về bảo hiểm/ Luât/ Y khoa_

Competencies /
_Năng lực lãnh đạo_
- Customer centricity - Foundation level / _Đặt khách hàng là trọng tâm_
- Execution Excellence - Foundation level / _Thực hiện công việc xuất sắc_
- Working together - Intermediate level / _Làm việc đội nhóm_


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