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Claims Fraud Analyst

Posted 23 March by QBE Financial Ended

QBE’s European Operations, which accounts for over 27% of QBE Group turnover, is a leading specialist in London market and European commercial lines business. Active in both the Lloyd’s and company market, QBE offers considerable diversity to the broking community. We are a socially responsible company and give our customers the ability to invest a portion of their premiums in environmentally and socially beneficial projects.

The Opportunity:

We are looking for a Claims Fraud Analyst to join our team this is your chance to create your career in an exciting environment where anything is possible. Are you ready to grow your career with us? As a Claims Fraud Analyst you will be analysing & researching all detected fraud claims, issue intelligence reports on behalf of the SIU (Special Investigation Unit) and QBE lines of business.

Your responsibilities for this role may include, but are not limited to

  • Support the SIU Claims Manager in the formation, delivery and management of counter fraud services to the business.
  • Manage a process for fraud risks identified by fraud prevention systems used by the SIU, to include research, referral/reporting to business areas, the SIU, adhering to SLA’s.
  • Prioritise matches for further action and investigation by the Company MLRO (Money Laundering Reporting Officer) as applicable.
  • Ensure timely and accurate loadings are made to fraud prevention systems, and ensure supporting records are in place, that are, compliant with the use of such systems.
  • Monitor and analyse the performance of Company fraud prevention systems, to include automated rules and scorecards, periodically recommending changes to rules and scorecards as applicable.
  • Using Company data and information ensure regular detailed analysis is undertaken to identify patterns and indicators of fraudulent activity, and timely reports produced for the SIU Claims Manager and business areas as applicable.
  • Complete ad-hoc data and information analysis at the request of the either the SIU management team, or Line of business operators
  • Work closely with the Claims Reporting & Insight Analysis team to ensure new and emerging fraud risks are promptly identified and reported on.
  • Assist with the testing of new fraud prevention systems and software.
  • Provide advice and support to business areas and SIU with regard to potential fraud risks.
  • Produce high quality written reports and advice for the business, to include recommendations.
  • Submit Suspicious Activity Reports as necessary to the Company MLRO.
  • Working knowledge of Excel, Access, Word, PowerPoint, Visio, Outlook and Internet Explorer. Experience in SQL or Analytical coding desired but not essential

You will need to be able to display you have the following qualifications and experience:

  • Interrogation and analysis of significant and complex data sets, to identify trends, patterns and indicators of fraudulent/ irregular activity.
  • Use of fraud prevention systems desired but not essential
  • Analysing and monitoring the performance of automated fraud prevention systems.
  • Ability to produce data analysis reports.
  • Strong claims experience desired but not essential
  • Knowledge and a solid understanding of relevant fraud related legislation & case law desired but not essential
  • Knowledge of FCA requirements (including TCF) and the regulatory framework relating to general insurance desired but not essential.

At QBE, we view our people as our most precious asset. We understand the importance of fostering a work environment that is responsive to the changing needs of today's workforce. QBE aims to build a workplace that is fair and inclusive because we want to attract and retain the best people to do the job. Search for QBE on Vercida to learn more about our Diversity and Inclusion programmes and policies.

Required skills

  • Fraud
  • Insurance Fraud
  • Intelligence
  • Fraud Claims
  • Fraud Detection

Reference: 34761365

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