Claims Fraud Investigator Role
This is a senior investigator position that involves managing a portfolio of investigations into suspected non-genuine or fraudulent claims, non-disclosure/misrepresentation, and policy breaches.
Responsibilities:
* Analyze suspected fraudulent and non-genuine general insurance (GI) and people risk claims.
* Manage a high volume of investigation referrals in compliance with industry standards, best practice guides, customer service protocols, and privacy requirements.
* Conduct thorough investigations including interviews into suspected non-genuine or fraudulent claims, non-disclosure/misrepresentation, and policy breaches focusing on best practices and evidence collection to derive claim outcomes.
* Supervise external investigative service providers to ensure effective and efficient services are provided.
* Provide strategic investigative advice to inform business decisions.
* Identify instances of fraud and factual anomalies in a timely manner.
* Implement appropriate actions to combat fraud/high-risk exposure.
* Collaborate with stakeholders to refine processes and procedures to improve fraud analysis and prevention.
Requirements:
* Significant experience in claims management in the general insurance area.
* Law enforcement or Insurance Investigation experience highly valued.
* Strong analytical focus and attention to detail.
* Excellent time management and ability to manage high work volumes and case loads.
* Ability to strategize investigations and evidence collection to enable informed business decisions.
Our organization is committed to creating an inclusive workplace culture where everyone feels valued and respected. We welcome diverse perspectives and experiences.
Our benefits include flexible working arrangements, life leave, parental leave, income protection insurance, and discounts on goods and services.
Our organization has received recognition for its commitment to diversity, equity, and inclusion, as well as health and wellbeing initiatives.