Fraud Officer

An opportunity has risen for a Fraud Officer role located within the Global Claims Risk Unit. Reporting to the Global Claims Risk Unit Supervisor, the Fraud Officer will be responsible for the assessment of complex & high risk claims, ensuring adherence to reasonable & customary costs, and referring those for further investigation to an appropriate Fraud Analyst. This is a strategic role, with a remit to maintain and execute best practice in the service delivery for Allianz customers.

What you do

• Assess claims for possible fraud & refer to fraud analysts for further investigation
• Examine & make recommendations on reasonable & customary costs in relation to regional medical expenses
• Support Claims Officers & Quality Assessors in the assessment of complex adjudication matters
• Provide insights & recommendations to improve cost containment results
• Implementation of claims cost containment processes as required
• Identify training gaps and make recommendations to the Global Operations Training Unit
• Identify & assist with the design & implementation of controls to mitigate leakage risk.
• Participate in the role of auditing in line with Operations Auditing Best Practice
• Provider administrative support to the Claims Risk Unit in relation to customer complaints, escalations, insight gathering, communications etc
• Ad Hoc Reporting as requested
• AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

What you bring

• Excellent level of written and verbal English is essential.
• Comfortable with problem solving & decision making
• At least 2 years’ experience in an International Health Insurance environment
• Experience in analyzing and assessing medical claims of high values and complexities
• Ability to communicate effectively with various audiences and all levels of the organization
• 2nd Language preferable
• Proficiency in MS Office (in particular in Excel, Power BI, PowerPoint)

How we hire 

Agency Statement Allianz Partners does not accept unsolicited CV’s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered

What we offer

Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners’ businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.

At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.

94004 | Finance & Accounting | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. 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. 

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust. 

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations. 

Great to have you on board. Let's care for tomorrow. 

Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz‘ company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.