Claims Examiner
5 hours ago
About Our Claims Investigation Role
Job SummaryWe're seeking a seasoned Investigator to spearhead our Claims Fraud Investigations team. As a key member, you'll be responsible for overseeing a portfolio of investigations into suspected non-genuine or fraudulent claims.
You'll work closely with the National Investigations Manager and Fraud Analysts to reduce QBE's fraud exposure across claims.
About You- You have extensive experience in claims management, specifically in the general insurance area.
- Law enforcement or Insurance Investigation experience is highly regarded.
- You possess strong analytical skills and attention to detail.
- You can strategize investigations and evidence collection to drive claim decisions and outcomes.
- Analyse suspected fraudulent and non-genuine general insurance and people risk claims.
- Manage a high volume of investigation referrals compliant with ICA Code of Conduct, 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.
- Instruct and manage external investigative service providers for effective and efficient services.
- Provide strategic investigative advice to claims teams.
- Detect instances of fraud and factual anomalies in a timely manner.
- Implement measures to combat fraud/high risk exposure.
- Contribute to refining processes and procedures to enhance fraud analysis.
- Able to adapt to legislative and industry changes.
- Excellent planning and time management skills with ability to meet competing priorities.
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