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Role Summary:
Claims Configuration Lead, who is responsible for working on standardizing claims process, design straight through processing rules as part of Claims transformation programme and work with technology, Data and AI teams to deploy them across Local Business Units (LBUs). This role ensures that claims process and rules are reusable across LBUs, rules are audited at the right frequency and enhanced when needed.
Roles & Responsibilities:
• Lead and support the strategic review and continuous improvement of the claims process to enhance efficiency, reduce turnaround times, and improve customer satisfaction.
• Work with LBUs to design STP (Straight-Through Processing) rules; followed by setting and maintaining rules in the claims platform
• to cooperate with AI team to develop AI based claims STP adjudication
• to work with Tech & LBUs on driving standardization in claims process, challenge deviations requested and document the deviations wherever really needed (PACS as the starting point and then go from there)
• Learn claims platform configuration to setup benefits and work with LBUs on ongoing product/benefits enhancements in the system
• Work closely with relevant business pillar owners, Technology, and customer service teams to ensure the successful implementation of process improvements, fostering a culture of excellence and customer-first thinking.
Skills & Requirements
• A Degree in computer science or equivalent.
• 10+ years of management experience overseeing large scale technology and process improvement projects
• Must have insurance industry knowledge with hands-on experience in claims transformation and adjudication
• Familiarity with claims adjudication, platform design frameworks, AI-driven FWA detection tools, and analytics capabilities
• Ability to lead organizational change and manage resistance while driving continuous improvement
• Strong experience in building user requirements, developing customer journeys, metrics and user acceptance testing,
• Demonstrate strong business acumen and problem-solving skills, strong verbal, written and presentation skills to communicate effectively with all levels across the organization, and excellent organizational skills and ability to handle multiple priorities while delivering timely & measurable results.
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.