Key Responsibilities
- Investigate suspected fraudulent claims thoroughly and objectively ensuring timely analysis and professional reporting.
- Analyze claim data and documents to identify patterns of abuse or fraud and recommend further actions.
- Collaborate with legal and law enforcement teams to support investigations including surveillance and evidence gathering.
- Ensure compliance with relevant policies regulations and procedures including financial and legal standards.
- Coordinate with internal teams (e.g. collections auditors) to track recoveries and provide accurate timely information.
- Maintain updated records and meet performance benchmarks for quality productivity and turnaround time.
- Support continuous improvement by contributing to process enhancements and aligning with best practices in claims management.
- Assist in preparing reports and statements to support departmental operations and decision-making.
Requirement
- Min 4 to 8 year experience (preferably relevant experience).
- Any University Degree or Diploma
- Employment Type - Outsource for 1 year (extension depending upon the project Scope.
- Local candidates with Valid QID Preferred
Key Responsibilities Investigate suspected fraudulent claims thoroughly and objectively ensuring timely analysis and professional reporting.Analyze claim data and documents to identify patterns of abuse or fraud and recommend further actions.Collaborate with legal and law enforcement teams to suppo...
Key Responsibilities
- Investigate suspected fraudulent claims thoroughly and objectively ensuring timely analysis and professional reporting.
- Analyze claim data and documents to identify patterns of abuse or fraud and recommend further actions.
- Collaborate with legal and law enforcement teams to support investigations including surveillance and evidence gathering.
- Ensure compliance with relevant policies regulations and procedures including financial and legal standards.
- Coordinate with internal teams (e.g. collections auditors) to track recoveries and provide accurate timely information.
- Maintain updated records and meet performance benchmarks for quality productivity and turnaround time.
- Support continuous improvement by contributing to process enhancements and aligning with best practices in claims management.
- Assist in preparing reports and statements to support departmental operations and decision-making.
Requirement
- Min 4 to 8 year experience (preferably relevant experience).
- Any University Degree or Diploma
- Employment Type - Outsource for 1 year (extension depending upon the project Scope.
- Local candidates with Valid QID Preferred
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