Claims Specialist

2 weeks ago

Sydney, New South Wales, Australia beBeeFraud Full time $90,000 - $120,000
Investigator Opportunities

This is a rare and exciting opportunity for an experienced investigator to join our team.

You will be responsible for managing a portfolio of investigations into suspected non genuine or fraudulent claims, non-disclosure/misrepresentation and policy breaches. This role will work closely with the National Investigations Manager and the Fraud Analysts to reduce fraud exposure across claims.

  • Analysing suspected fraudulent and non-genuine general insurance (GI) and people risk claims.
  • Manage a high volume of investigation referrals compliant to Code of Conduct, best practice guides, customer service protocols, and Privacy requirements.
  • Manage and perform investigations including interviews into suspected non genuine or fraudulent claims, non-disclosure/misrepresentation and policy breaches focusing on best practice, and collection of evidence to derive claim outcomes.
  • Instruct and manage external investigative service providers to ensure effective cost and efficient services are provided.
  • Provide strategic investigative advice to claims.
  • Interpret data and detect instances of fraud and factual anomalies in a timely manner.
  • Implement appropriate action to combat fraud/high risk exposure.
  • Contribute to refinement of processes and procedures to improve fraud analysis and procedures.
  • Ability to adapt to legislative and industry changes.

About You:

  • Extensive claims management experience in general insurance area.
  • Law enforcement or Insurance Investigation experience highly regarded.
  • Strong analytical focus and attention to detail.
  • Strong time management and ability to manage high work volumes and case loads.
  • Ability to strategize investigations and evidence collection to enable claim decisions and outcomes.

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