Claims Investigation Specialist

**PURPOSE OF ROLE**

The Claims Investigation Specialist will lead, coach, and develop a team of analysts to make informed decisions that mitigate risk and drive strategic actions. Monitor and improve performance, engagement and productivity and assist analysts to develop effective investigative and claims resolution strategies of potentially fraudulent claims.

This role will work closely with the 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.

**POSITION 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.
- Lead 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 ensure 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.
- Continue to nurture a high performing and engaged workforce promoting a culture of “one team” across all three sites (North Lakes, Kawana and Toowong).
- 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, (such as performing risk assessments and testing health and safety procedures) 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.
- Providing 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.

**What experience you’ll bring;**
- A degree in investigations, intelligence or data analysis would be preferable.
- A background in a fraud environment is desirable.
- Demonstrated experience in leading people and driving a collaborative, high-performance culture.
- Strong Stakeholder engagement, team, and management skills.
- Relevant experience in customer resolution and complaints management.
- Strong ability to coach, motivate and influence team members in a fast-paced environment with the ability to deliver difficult feedback constructively.
- Demonstrated knowledge of counter fraud techniques, Code of Practice, non-disclosure and ‘utmost good faith’ is preferable.
- Police investigative or intelligence experience will be favorable.
- Ability to pass a National Police Check
- Proven data intelligence & statistical analytical experience, (analysis of large data sets with a previous fraud investigation, research, and analysis experience).
- Demonstrable skills translating data analysis into sound business recommendations (i.e. in clear ROI terms), in a confident, credible way and able to clearly identify and articulate the risks and opportunities to our business
- Well-developed and demonstrated understanding of the legislative, regulatory and compliance obligations to operate in the FSR environment.

**The benefits of working at A&G**
- ** Location** - This will be based in the Toowong office with cross site travel expected.
- ** Be rewarded** - we recognise high performance and reward our people for their hard work through bonuses and other perks.
- ** Options for leave** - life happens, so we’ve got volunteer days, an additional paid ‘ME’ day, paid parental leave and the opportunity to purchase additional leave to cover all of the big stuff.
- ** Grow with us** - we’ve got learning and professional development opportunities to suit everyone.
- ** Give back**:

- our A&G Difference program gives you the power to change our community for the better through volunteering, fundraising and donation opportunities for causes that you’re passionate about.
- ** Take care of yourself** - your wellbeing is important to us and our healthy mind and body hub, mental-health support and fitness discounts will help you be your best self.
- ** Celebrate the wins** - we love sharing our successes and celebrating together - join us