Claims Fraud Analyst / Investigator

Job Summary

• Responsible for identifying, investigating, and preventing fraudulent claims within the organization.
• This role involves utilizing advanced data analytics, conducting thorough investigations, and collaborating with various departments to mitigate fraud risks.
• Be successful in this role, you require strong analytical skills, attention to detail, and a proactive approach to fraud prevention.

Job Accountabilities

Fraud Detection and Prevention

• Identify, investigate, and analyze potential fraudulent claims
• Develop and implement strategies to prevent fraudulent activities

Data Analysis

• Utilize data analytics tools to detect patterns and anomalies indicative of fraud
• Maintain and analyze databases of fraud-related information

Investigation

• Conduct detailed investigations into suspicious claims
• Gather and review evidence, including documents, interviews, and surveillance

Reporting

• Prepare detailed reports on investigation findings
• Communicate findings and recommendations to management and other stakeholders

Collaboration

• Work closely with other departments, such as Underwriting, Legal, and Compliance, to address fraud issues
• Liaise with external agencies, such as law enforcement and regulatory bodies, as needed

Continuous Improvement

• Identify areas for improvement in fraud detection processes and recommend enhancements
• Participate in the development and implementation of new fraud detection tools and technologies

Job Qualifications

• Bachelor degree, preferably in Computer Science / Engineering/ Information Systems/ Statistics/Criminal Justice/ Finance/ Law or any other related discipline
• Minimum of 1 - 2 years of experience in claims fraud investigation, financial fraud, process automation, business process analysis, or a related field
• Experience in the insurance industry is highly desirable
• Insurance qualification is preferred but not essential
• Proficiency in data analytics tools and software (e.g., SQL, Excel, SAS, Python, R, C++ etc.)
• Commercial and practical experience with data visualization, dashboard, and report development is advantageous
• Strong interpersonal skills with the ability to collaborate with various departments and external agencies
• Fast learner with high energy and the ability to thrive in a fast-paced, customer-focused environment
• Recognition of the importance of providing excellent customer service
• Excellent communication skills, with proficiency in spoken and written English
• Candidates with different levels of experience will be considered for other positions

Why Zurich

At Zurich, we like to think outside the box and challenge the status quo. We take an optimistic approach by focusing on the positives and constantly asking What can go right? 

We are an equal opportunity employer who knows that each employee is unique - that’s what makes our team so great! 
Join us as we constantly explore new ways to protect our customers and the planet.
 

• Location(s): HK - Hong Kong