Claims Specialist - Fraud Investigation Unit (SG Market)

At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.

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About the Role

Responsible to conduct thorough review of the customer and claims, obtaining evidence, producing report on findings as per stipulated requirements and benchmark

Responsible to conduct thorough review of the customer and claims, obtaining evidence, producing report on findings as per stipulated requirements and benchmark

• Assess customer profiles, policy details and claim history (all policies).

• Review claim patterns/trends nature of injuries, treating doctors, clinic address and residential/workplace.

• Conduct interviews with the servicing agent, medical doctors and claimant.

• Verify claim document, analyze signs of potential forged documents and clarification with hospital.

• Gather all information and prepare preliminary investigation report to Fraud Team (SG).

• Provide training session to claims assessors on fraud detection and best practices.

• Ensure that targets in line with KPI goals.

• Performs other tasks periodically assigned by supervisor to meet operational and/or other requirements.

Qualification

• Sound knowledge in medical claims & personal accident

• Minimum 3-5 years experience in end-to-end claims processing

• Available to work on-site in Cyberjaya's office

• Excellent written and spoken English language proficiency. Mandarin language proficiency is an added bonus (due to market requirement)