Strategic Risk Mitigation Professional

1 week ago

Brisbane, Queensland, Australia beBeeRiskAssessment Full time $125,000 - $175,000
Claims Investigation Specialist Role Overview

The Claims Investigation Specialist will lead a team of analysts in making informed decisions to mitigate risk and drive strategic actions. They will monitor and improve performance, engagement, and productivity while assisting analysts in developing effective investigative and claims resolution strategies for potentially fraudulent claims.

This role will collaborate closely with Investigation Team Leaders, Data and Analytics, and Quality Analysts to ensure compliance with current regulatory obligations, meet best practice guidelines, and enhance automation and optimisation across the Specialised Claims teams.

Primary Accountabilities:

  • Lead the Risk Assessment Hub to deliver optimal claims and operating cost outcomes, high-level customer service in a strong control environment.
  • Design and deliver predictive analytics to assist fraud identification and prevention.
  • Develop education programs across Auto & General to increase fraud referrals into Investigations in line with industry benchmarks.
  • Maintain regular reporting and monitoring of the team, including KPI's.
  • Ensure your team complies with all requirements relating to risk management activity and constantly ensures that risk management is at the forefront of your teams' culture and processes, acting where this is not the case.
  • Promote a high-performance culture through staff engagement and productivity.
  • Work with the leadership team to ensure consistency in claims assessment, process, and culture.
  • Develop intelligence opportunities and profile high-risk networks and professional enablers (associated professionals who are complicit in submitting and progressing fraudulent claims) to ensure that Auto & General fraud exposure is minimised.
  • Interpret policy to develop and review intelligence systems, procedures, and practices to introduce improvements.
  • Maintain awareness of innovation within intelligence to ensure implementation of latest techniques and tactics, best practice, and information relevant to the role.
  • Provide vision and leadership to ensure maturation of business intelligence within Auto & General.
  • Support development and review of all Operating Procedures and documentation to ensure compliance with current regulatory obligations, standards, and Auto & General guidelines.
  • Monitor compliance to regulations and oversee the continuous improvement of controls.

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