Job Responsibilities:

• Collaborate with in-house & external service providers i.e... surveyors, lawyers, experts and claims assessors to assure excellence and high quality of the services provided.
• Proactively monitor and review any activities, transactions and data suspected of possible fraud and potential recovery by utilizing appropriate analytical techniques.
• Ensure Technical Excellence in Fraud Fighting & effectiveness of Allianz anti-fraud policy and adherence to anti-fraud Claims guideline. As well as shares in setting strategy and address Fraud Fighting practices for all lines of business.
• Capability to assess & evaluate fraud risks in claims and recommend for mitigation. Review claims process, job structures, authority limits and anti-fraud guidelines with the head of claims and take up the gaps with concerned unit manager for closure.
• Ensure periodic review of CFR & OFR to assure high service quality and report to the Head of Claims and maintain detailed records of all the suspicious & detected fraud cases and provide recommendations for mitigation and/or prevention.
• Identify claims leakages, SLA’s deviations, red flags indicators and propose remedy actions, security controls to protect P&C claims from future fraudulent incidents
• Encourage and participate in and provide training to staff about Anti-Fraud, Potential Recovery and assure on job training is conducted with the new claim’s assessors.
• Ensure that the team are aware of Allianz code of conduct, Recovery & Anti-Fraud guidelines.
• Coordinate with the Service providers to maintain periodical training to the claims team as well as fixing a periodical meeting with the service providers to follow up each case and review their performance.
• Support Claims team in claims handling & settlement -according to workload and upon a direct request from the Head of Claim- during this task the performance will be reported by both Motors & Non-Motors Claims Managers.
• Responsible for monitoring, manage performance & report all Recovery (subrogation & salvage) cases, ensure that potential recovery cases aren't missed and are concluded in an efficient way as possible.

Job Qualifications:

• 7 – 10 years of experience in audit, process analysis and quality controls.
• Bachelor’s degree in law, accounting, or Experience in a law enforcement field are the minimum requirements of this role.
• Experience in quality improvement preferred.
• Competent in coordinating and directing the operations of fraud investigation teams to ensure the resolution of fraud cases.
• Fraud investigation skills in conducting analysis of claims records to identify inconsistencies
• Communication Skills with fraud investigators, service providers, in-house surveyors and claims assessors to establish the objectives of his roles.