Employer: American International
Location: Johannesburg
Position Description
We are seeking a Principle Fraud Investigator who will be responsible to manage the fraud programme for multiple countries as assigned within the region. This position requires the identification and investigation of suspicious insurance claims or suspicious insurance related activities covering all lines
of business involving claimants, agents, brokers, attorneys, medical providers, etc. The position supports the claims and underwriting organizations with an end to end fraud program to assist in making appropriate claims adjudication decisions or pursue appropriate remedies through the civil or criminal justice systems.
Reporting into the Head of Claims, this position is based in Johannesburg South Africa. There is a matrix reporting into Global Investigative Services Regional Head.
Specific responsibilities will include:
-Gather facts on issues in question through open ended interviewing and statement taking of witnesses, employers, claimants and other relevant witnesses;
-Obtain an preserve physical and documentary evidence to support the claims adjudication decision;
-Manage the assignment and investigative requirements of third party investigators to support the investigative process if necessary;
-Preparing objective and concise written reports of investigations as necessary;
-Testifying and presenting evidence at administrative and criminal court proceedings as required;
-Establishing and maintaining professional working relationships with insured's, claimants, witnesses, attorneys, corporate employees, criminal justice agencies, and the general public;
-Identify, create and complete fraud training and awareness campaigns for various lines of business supported by Chartis;
-Complete targeted claims reviews for all lines of business within Chartis as assigned by the regional head of GIS. This includes analysis, documentation of results and suggestions for improving the detection and handling of suspicious claims;
-Provide intelligence feedback to claims and underwriting regarding loss trends and potential opportunities as identified;
-Collect and verify all monthly fraud metrics data for timely submission to the regional head;
-Take an active role in the insurance fraud associations to raise awareness of Chartis anti fraud efforts and to keep in tune with the latest trends and changes in the industry;
-Take an active role in promoting the anti-fraud program, monitoring office performance and providing solutions for improvement as necessary.
Position Requirements
The successful candidate will possess the following technical skills and expertise:
-Strong analytical decision making, problem solving and communication (oral and written) skills;
Fluency in spoken and written English;
-Demonstrated ability to manage and prioritize case load with limited supervision;
-Demonstrated abilities in time management and establishing priorities;
-Understanding of insurance terms and policy interpretation;
-Ability to organize data and write investigative reports;
-Advanced knowledge of criminal justice and civil legal systems;
-Ability to alter work flow to create and pursue leads that would support a fraud case;
-Willing and able to travel, to include possible overnight stays for extended periods of time and work irregular days and hours as required;
-A minimum of 7 years insurance fraud investigative experience or ten years of general investigative related experience a must;
-Four year Degree preferred
In addition:
-good computer literacy skills and experience with various database search capabilities;
-Demonstrated ability to train and improve the performance of others regarding fraud detection and investigation.
About Us
American International Group, Inc. (AIG) is a leading international insurance organization serving customers in more than 130 countries and jurisdictions. AIG companies serve commercial, institutional, and individual customers through one of the most extensive worldwide property-casualty networks of any insurer. In addition, AIG companies are leading providers of life insurance and retirement services in the United States.
AIG Property Casualty is a global market leader, one of the few truly global property casualty franchises.
AIG Life and Retirement is one of the largest life insurance organizations in the U.S., and provides protection, investment and income solutions needed for financial and retirement security.
United Guaranty Corporation is the marketplace leader in mortgage insurance in the U.S.
Additional information about AIG can be found at www.aig.com | YouTube: www.youtube.com/aig | Twitter: @AIG_LatestNews | LinkedIn: http://www.linkedin.com/company/aig
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