Claims Investigator (Claims Control & Specialised Claims) Summary of Job: We are seeking a highly skilled professional to join our Claims Control & Specialised Claims Unit.
As a key member of our team, you will be responsible for Market Intelligence, serving as a Claims Specialist, overseeing Performance Management, and handling Fraud Management.
Your expertise will ensure efficient and effective claims processing while safeguarding against fraudulent activities.
If you're passionate about claims and have a keen eye for detail, we want to hear from you!
Key Responsibilities: To perform and/or oversees the following duties and responsibilities within the department: Regular review of open files in order to identify root causes of claims leakage and the translation of those findings into action plans to reduce leakage through process improvements and/or training.
To manage the specialised claims from point of notification up to settlement i.e.
manage the progress of Adjusters investigation.
Periodic monitoring outstanding claim files with Adjusters.
Review work processes and provide solutions in improvement of claim guidelines and work processes.
To assist in department's administrative works, systems and procedures for smooth operations and continuous improvement.
Performs investigation of potential fraud cases to uncover the fraud pattern and also the parties involved.
Developing claim reviews plans (including outstanding and closed cases).
Review, investigate and actively involved in all complex and contentious claims referred to the team to ensure compliance with policy requirements and smooth settlement.
Analyses and maintains an up-to-date knowledge and data of fraud trends in the market.
Backup team members and assume the responsibilities as and when required.
Perform other duties as delegates by the Management.
Ensure compliance to policies, guidelines and regulations.
59010 | Customer Services & Claims | Professional | Non-Executive | Allianz Malaysia | Full-Time | Permanent Allianz Group is one of the most trusted insurance and asset management companies in the world.
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Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer.
We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
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