Fraud Officer

Job description / Role

We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has a number of well-known customer facing brands such as Allianz Care, Nextcare and Medi24.

The International Health line of business provides international health, life and disability insurance and services, reinsurance and administration services to a wide range of customers. These include multinational companies, intergovernmental organisations (IGOs), non-governmental organisations (NGOs), private individuals, families and students. Our mission is to ensure that customers have access to quality healthcare through our support, care and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment and value for our customer.

JOB OVERVIEW

An opportunity has risen for a Fraud Officer role located within the Global Claims Risk Unit. Reporting to the Global Claims Risk Unit Supervisor, the Fraud Officer will be responsible for the assessment of complex & high risk claims, ensuring adherence to reasonable & customary costs, and referring those for further investigation to an appropriate Fraud Analyst. This is a strategic role, with a remit to maintain and execute best practice in the service delivery for Allianz customers.

RESPONSIBILITIES / what you do
Responsibilities will include, but are not limited to, the following:

- Assess claims for possible fraud & refer to fraud analysts for further investigation
- Examine & make recommendations on reasonable & customary costs in relation to regional medical expenses
- Support Claims Officers & Quality Assessors in the assessment of complex adjudication matters
- Provide insights & recommendations to improve cost containment results
- Implementation of claims cost containment processes as required
- Identify training gaps and make recommendations to the Global Operations Training Unit
- Identify & assist with the design & implementation of controls to mitigate leakage risk.
- Participate in the role of auditing in line with Operations Auditing Best Practice
- Provider administrative support to the Claims Risk Unit in relation to customer complaints, escalations, insight gathering, communications etc
- Ad Hoc Reporting as requested

REQUIREMENTS / What you bring
To be successful in this position you will need to have the following skills/experience:

- Excellent level of written and verbal English is essential.
- Comfortable with problem solving & decision making
- At least 2 years' experience in an International Health Insurance environment
- 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
- 2nd Language preferable
- Proficiency in MS Office (in particular in Excel, Power BI, PowerPoint)

As an equal opportunity employer, Allianz Partners recognizes that our strength lies in our people and we are committed to diversity and inclusivity. So if you would like to be part of a global company that offers international career opportunities, kick-start your career and dare to join us!

About the Company

With over 159,000 employees from 172 nationalities across more than 70 countries, we are one of the world's most trusted insurance and asset management companies. We offer a broad range of products and services in property/casualty insurance, life/health insurance, and asset management. We have our largest operational presence in Europe, and our parent company, Allianz SE, is headquartered in Munich, Germany. From jobs in Actuarial, Business and IT to Inhouse Consulting and Investment Management - your opportunities are endless!