Requirements;
- Min Bachelor Degree degree in any major
- Min 6 years working experience on Fraud Claim Management area and preferably with audit and investigation skills background.
- Experiences with Fraud Claim, Claim Audit and Claim Investigation Communication.
- Solid knowledge and strong competency of general insurance business and claim process.
- Certified Fraud Examiner (CFE) is a plus.
- Excel and Power BI
- Dana Analytic Skill, Audit and Investigation skills
- Implement and monitor company's strategy towards improving fraud saving.
- Identify potential frauds through regular CFR (Close File Review), OFR (Open File Review) and incidental reports/indications by team Claim or other parties.
- Assess the extent, materiality, and factuality of suspicious cases through on-site and/or off-site investigations.
- Propose recommendation for follow up on confirmed fraud cases to relevant departments.
- Produce Fraud Reports for both regional and internal purposes.
- Investigate any suspicious claims.
- Produce CFR & OFR Report with proposed/recommended corrective actions.
- Analyze monthly data set for potential fraud identification and recommendation for improvements.
- Set proper fraud alert rules for fraud detection and analysis purposes and continuously updating and monitoring the implementation of fraud rules to prevent fraud effectively.
- Improve fraud awareness among claim staffs through socializations and/or publications.
- Propose recommendation for follow up on confirmed fraud cases to relevant departments.
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