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 P&C Claims Quality Assurance - Fraud Specialist
  • Analyze and verify suspicious fraud cases referred from several channel such as Surveyor, Internal Staff or Business rule
  • Perform investigation of fraud case from fraud management system, contact center and other channels of which fraud is raised and revert the result within SLA
  • Professional contact with customer or concerned parties to resolve disputation within SLA
  • Understand fraud operation process and Communicate skill to support Management their discoveries for further, in-depth investigations.
  • Proactively conduct investigations with the goal of developing cases to a successful conclusion. This will involve identifying trends and patterns.
  • Analysis data and Preparing fraud investigation performance monthly or ad hoc report to management
  • Able to support for emergency case
  • Bachelor’s Degree in appropriate field of study or equivalent work experience
  • Experience in fraud resolution
  • Insurance knowledge, procedures, Regulator and rules
  • Ability to work independently and with others
  • Problem solving skills and attention to detail
  • Operational control

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