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Counter Fraud Investigator

Counter Fraud Investigator

Posted 8 June by GerrardWhite
Easy Apply Ended

Counter Fraud Investigator

Location: Central Nottingham - Nottinghamshire

Salary: £22,000 - £35,000

Full Time and Permanent

Role Description

The main purpose of this role is to review potentially fraudulent home claims, applying technical/analytical thinking into the decision-making process. Applying logic and commercial sense when making the decision on whether further investigation is needed. When further investigation is needed to appoint suppliers or retain in house investigation and to maintain a good working relationship with suppliers. The role will be key in taking steps to protect the business from the threat of insurance fraud by identifying suspected fraudulent claims and contributing to the claims fraud savings target.

Responsibilities

  • Review potentially fraudulent home claims, making an informed decision on whether a further investigation is warranted. Arranging the investigation through retention in HLT or through an appropriate supplier, where necessary or facilitating settlement on claims where no concerns are identified.
  • Provide support, advice, guidance and information in area(s) of specialism to resolve enquires and requests effectively from other areas of the business.
  • Apply specialist knowledge, skills and appropriate behaviours effectively to achieve a successful outcome while maintaining the highest possible level of customer satisfaction, referring to more senior staff when appropriate.
  • Produce and process all documentation in an accurate and timely manner and ensure that the information passes to colleagues responsible for these activities.
  • Ensure at all times the advice and services provided are consistent with all relevant procedures, processes, standards, behaviours and performance targets.
  • Participate in activities to plan and implement activities to improve operating processes or procedures.
  • Keep up to date in area of specialism and develop skills and capabilities.
  • Maintain knowledge of regulatory and legal requirements relevant to the role. Support and promote compliance with those requirements within the role and the business.
  • Ensures consistent Best Practice is adopted for reporting requirements on Proven Fraud claims to SIRA, IFB, IFR and IFED where applicable.
  • Develop and maintain an extensive knowledge and experience of relevant products, services and solution frameworks.
  • Support the work of team colleagues, providing appropriate help, thereby enabling the team to improve its capability, to operate efficiently and maximise performance.
  • Support performance assessments and contribute to activities to improve the suitability and quality of the support provided.
  • Understand the complaint handling procedure and ensure any complaints received are recorded in line with this process.
  • Responsible for appropriately and compliantly acting upon industry intelligence in order to protect the business from the threat of Insurance fraud.
  • Responsible for submitting to the IFB Intelligence submissions, where appropriate, in order to assist both the business and Wider Industry in counter-Fraud activity
  • To compliantly handle regulatory disclosure requests under Schedule 2.1.2 of the Data Protection Act if required.
  • To work closely with the Fraud Underwriting Area in order to ensure that the business have a joined up and holistic approach to tackling insurance fraud.

Key Qualifications

  • 12 months experience of claims fraud and/or associated fields.
  • Able to assess the potential impact of emerging developments in Fraud and how to apply them in the business context
  • Good understanding of industry issues
  • Good understanding of the provisions of Section 2.1.2 of the Data Protection Act
  • Strong analytical skills
  • A frontline expert in Claims
  • Understand what is needed to meet internal and external customer requirements
  • Ability to plan and prioritise effectively
  • Broad understanding of company policies
  • Developed analytical and problem solving skills
  • Demonstrated ability in stakeholder management
  • Well-developed persuasive skills
  • Strong time management skills and ability to maintain a diverse work schedule
  • Communicates both written and verbally in style appropriate to audience
  • Good understanding of relevant operational and IT systems

Reference: 42976893

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