Claim Fraud Management Assistant Manager

Requirements; - Min Bachelor Degree degree in any major - Min 6 years working experience on Fraud Claim Management area and preferably with audit and investigation skills background. - Experiences with Fraud Claim, Claim Audit and Claim Investigation Communication. - Solid knowledge and strong competency of general insurance business and claim process. - Certified Fraud Examiner (CFE) is a plus. - Excel and Power BI - Dana Analytic Skill, Audit and Investigation skills - Implement and monitor company's strategy towards improving fraud saving. - Identify potential frauds through regular CFR (Close File Review), OFR (Open File Review) and incidental reports/indications by team Claim or other parties. - Assess the extent, materiality, and factuality of suspicious cases through on-site and/or off-site investigations. - Propose recommendation for follow up on confirmed fraud cases to relevant departments. - Produce Fraud Reports for both regional and internal purposes. - Investigate any suspicious claims. - Produce CFR & OFR Report with proposed/recommended corrective actions. - Analyze monthly data set for potential fraud identification and recommendation for improvements. - Set proper fraud alert rules for fraud detection and analysis purposes and continuously updating and monitoring the implementation of fraud rules to prevent fraud effectively. - Improve fraud awareness among claim staffs through socializations and/or publications. - Propose recommendation for follow up on confirmed fraud cases to relevant departments. Originally posted on Himalayas