Lead, Claims Servicing (H&P Club)

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.
Job Profile Summary
In this role, the incumbent is responsible for leading a dedicated servicing team that provides premium claims support to qualified Health & Protection (H&P) Club members. The role acts as the key bridge between the H&P Club qualifiers and our claims team to deliver exceptional service experiences throughout the claims journey, which includes claims adjudication of all claim types (Health and Protection) within the stipulated SLA.
The incumbent will ensure timely resolution of claims-related enquiries, champion service excellence, drive customer advocacy, and provide leadership to a team of Claims Servicing Specialists. The role is focused on servicing and relationship management aside to claim adjudication, enabling qualified advisers and their customers to receive proactive support and timely updates on claims matters within stipulated turnaround.
Job Description
1. People Management
Lead, coach and develop a team of Claims Servicing Specialists.
You will lead a team of four claims specialists
Drive a customer-centric culture focused on responsiveness, professionalism and empathy.
Set service standards, team objectives and performance expectations.
Conduct regular coaching, capability development and quality reviews.
Foster a collaborative and high-performing work environment aligned with Prudential Values and PRUWay behaviours.
2. Premium Claims Servicing
Oversee end-to-end servicing support for H&P Club members and their customers.
Ensure prompt resolution of claims enquiries and service requests (within 24 hours in claims resolution).
Act as the escalation point for complex and sensitive service issues.
Coordinate with Claims Assessors to facilitate claim progression and timely communication.
Provide proactive updates to H&P advisers on critical, urgent and high-impact claims cases.
Drive service recovery efforts where service expectations are not met.
3. Stakeholder Management
Build strong partnerships with:
H&P qualifiers
Claims BAU team
Healthcare Institutions
Technology Teams
Serve as the primary point of contact for escalated H&P Club servicing matters.
Support agency engagement sessions and feedback forums to continuously improve service delivery.
4. Operational Excellence
Monitor and manage:
Service turnaround times (within 24 hours of the enquiry)
Productivity metrics
Quality standards
Distribution feedback
Identify service gaps and implement process improvements.
Support operational readiness for system enhancements and service initiatives.
Drive efficiency through automation and digital servicing opportunities.
5. Governance, Risk and Compliance
Ensure all servicing activities comply with:
Internal policies and claims SOPs
Regulatory requirements
Data privacy obligations
Audit requirements
Ensure accurate documentation of customer interactions and servicing actions.
Support audit reviews and remediation activities where required.
Escalate operational risks and customer issues in a timely manner.
6. Transformation and Continuous Improvement
Participate in strategic initiatives related to claims servicing transformation.
Support implementation of AI-driven servicing capabilities and digital customer journeys.
Collaborate with business and technology teams in:
Requirement gathering
User Acceptance Testing (UAT)
Process redesign
Service enhancement initiatives
Use customer and adviser feedback to drive continuous improvements.
Support the team on Quality Checks for STP claims, both inpatient and PP claims and report back (feedback loop) to the Team Leads and Technical team
Who Are We Looking For:
Qualifications & Experience
Diploma or Degree in Healthcare, Insurance, Business, or Administration or related discipline is preferred
Minimum 5-8 years of experience in Health and Life Claims, Customer Service, Insurance Operations, or Healthcare Administration.
At least 2-3 years in a leadership or supervisory capacity.
Strong understanding of:
Life plans
Integrated Shield Plans
Health insurance claims processes
Customer servicing operations
Regulatory and governance requirements
Skills & Competencies
Strong passion for customer advocacy and service excellence
Data-driven and results-oriented with a continuous improvement mindset.
Ability to inspire, motivate and develop high-performing teams.
Builds trusted partnerships across multiple business functions.
Able to navigate complex servicing situations and develop practical solutions.
Able to multi-task in a fast-paced environment
Able work under pressure and fulfil last minute tasks assigned within tight timeline and manage high claim volumes
Proficient in Microsoft Office (Excel, Word) and claims systems (preferred)
Excellent verbal and written communication skills.
Responsible and reliable with strong work discipline
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.