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Claims Fraud Specialist

2 weeks ago

Melbourne, Victoria, Australia beBeeFraud Full time $90,000 - $120,000

About the Role

This is a rare and exciting opportunity to take on a challenging Investigator position within a Claims Fraud Investigations team.

  • Responsibility for analysing suspected fraudulent and non-genuine general insurance (GI) and people risk claims.
  • Manage a high volume of investigation referrals in accordance with industry standards, customer service protocols, and data protection regulations.
  • Investigate claims involving suspected non-disclosure/misrepresentation and policy breaches, focusing on best practice and evidence collection to derive claim outcomes.
  • Collaborate with external investigative service providers to ensure effective and efficient services are provided.
  • Provide strategic advice on investigations to support informed decision-making.
  • Interpret data to identify instances of fraud and factual anomalies in a timely manner.
  • Implement measures to combat fraud/high risk exposure.
  • Contribute to process refinement and procedure improvement initiatives to enhance fraud analysis and prevention.
  • Ability to adapt to legislative and industry changes.
  • Excellent planning and time management skills with the ability to meet competing priorities.

About You

  • Significant experience in claims management within the general insurance sector.
  • Law enforcement or Insurance Investigation background highly regarded.
  • Strong analytical focus and attention to detail.
  • Effective time management and ability to handle high work volumes and case loads.
  • Ability to strategize investigations and evidence collection to enable informed claim decisions and outcomes.