Senior Fraud Analyst

Key responsibilities/What you do:

• Represent the Global Claims Risk Unit as a Fraud Management Subject Matter Expert(SME) for cross functional activities, Client Updates, New Business Solutions and Auditing
• Analyze claims data to identify unusual patterns and potential fraud indicators.
• Support the Fraud Analysts throughout the Fraud Process (Identification, Investigation, Corrective Actions)
• Conduct thorough investigations into suspicious claims, including interviewing claimants and gathering relevant documentation.
• Utilize advanced analytics and fraud detection tools to enhance fraud detection capabilities.
• Perform detailed data analysis to uncover trends and anomalies indicative of fraudulent activities.
• Prepare comprehensive reports on findings, including actionable recommendations.
• Participate in cross-functional teams to develop and implement fraud prevention strategies.
• Ensure all fraud detection and investigation activities comply with internal policies, external regulations, and industry standards.
• Maintain accurate and detailed records of investigations and outcomes.
• Prepare and present fraud reports to senior management and stakeholders.
• Identify opportunities to enhance fraud detection and prevention processes.
• Stay current with industry trends, emerging threats, and new technologies in fraud prevention.
• Provide training and guidance to junior fraud analysts and other staff on fraud detection techniques and best practices.
• Mentor team members, fostering a culture of vigilance and proactive fraud prevention.
• Take part in other projects when required, review documentation and contribute where applicable, research information relating to your area and provide feedback.
• Other Ad hoc duties as required

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

Key requirements/What you bring:

• Bachelor’s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
• At least 5 years’ experience in analysing and assessing medical claims of high values and complexities
• With proven track record in Fraud mitigation
• Strong ability to communicate effectively with various audiences and all levels of the organisation
• Proficiency in MS Office (in particular in Excel, Power BI, PowerPoint)
• Excellent level of written and verbal English is essential.
• High level of solution orientation & decision making
• Have obtained or be working towards 1 or more of the following:
• Fraud (eg ACFE
• Medical Qualification
• Data Analytics
• International Medical Coding
• Legally permitted to work in the country of operations.
• Hybrid working option available as per business requirements.

How we hire 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.