Senior Fraud Analyst

Overview

• The Fraud Analyst role plays a key part in our global claims cost containment strategy.
• The ideal candidate will have an inquisitive mind and be focused on ensuring we prevent fraudulent activity/ waste and abuse at all stages of the claim journey.
• The role requires the ability to multitask across numerous disciplines within the global claims department and is ideally suited to a strong self-starter with excellent time management skills and a desire to develop within the organization
• Key responsibilities/What you do:
• Identify investigate fraudulent activities on ADNIC Health Claims and present fraud reports to the relevant stakeholders
• Participate in the role of Auditing FWA Reporting of ADNIC Health Claims in line with Operations Auditing Practices, and regulatory requirements.
• Review and assess other areas of fraud, waste abuse risk across ADNIC portfolio to identify potential fraud or misrepresentation.
• Identify report cost containment opportunities.
• Provide input into Operations Controls to achieve acceptable cost containment fraud identification standards.
• Create Facilitate Anti-Fraud Awareness support material as required
• Liaise with Global Operations Functions to ensure consistency in the application of the Global Claims Fraud Framework across ADNIC Health Claims
• Respond to client enquiries accurately and professionally and when necessary, liaise with additional departments to ensure an efficient response is given thereby achieving client satisfaction.
• Other Ad Hoc tasks or projects in order to support the team and other areas of the business
• 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.
• Minimum 2 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or health insurance roles.
• Experience in problem solving decision making
• Excellent level of written and verbal English is essential.
• Comfortable with problem solving decision making
• 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
• Proficiency in MS Office (in particular in Excel, Power BI, PowerPoint)
• Legally permitted to work in the country of operations.
• Hybrid working option available as per business requirements.2nd Language preferable
• 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.
• Key benefits/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.
• Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.
• We at Allianz believe in a strong inclusive culture that encourages people to speak their minds, get involved and question the status quo.
• We are proud to be an equal opportunity employer and 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 race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristics protected under applicable local laws and regulations.
• At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions.
• These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times.
• Our AI-powered technology has made claims processing faster, offering quicker resolutions.
• All while ensuring human oversight for claims to maintain service integrity.
• By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions.
• Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations.
• This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
• Great to have you on board.
• Let's care for tomorrow.