SIU Investigator - Pembroke Pines, FL

Only for registered members Pembroke Pines, FL, United States

2 weeks ago

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+

Job summary

+Embark on a journey that makes a difference.
At Generali Global Assistance, every day is an opportunity to help people explore the world with confidence.+

+

Responsibilities

+Triage and investigation of the most complex/high value alerts reported by Claims Ops.<+Collaborate with external Investigation Partners.+Investigate Fraud patterns reported by other departments: UDW / Actuarial / Finance Teams.+Identify suspicious cases / fraud patterns by your own, leveraging data analysis.+Support in the detection/triage phases.+Support in the Deny process.+Contribute to the definition of manual detection procedures in close collaboration with Claims Supervisors/ Managers.+Identify new fraud scenarios for fraud training program purposes, anti-fraud tool improvement and manual detection procedures improvement.+Completion of the Quarterly Fraud Report: savings amount, investigation status+Contribute to our continuous enrichment of the Fraud KPIs list.+Be an active contributor of the Fraud Operational Committees.+Act as an anti-fraud expert within the company, supporting peers to continuously improve maturity level.+
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