Senior Associate - Claims (Fraud, Waste & Abuse)

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

Sound like you Then read on.

About the Role

1) Conduct fraud, waste and abuse (FWA) investigations through structured, risk‑based and analytics‑supported approaches to support effective fraud detection, prevention and mitigation

2) Perform end‑to‑end fraud investigation activities by analyzing claims, transactional and behavioral data to identify suspicious patterns, emerging fraud typologies and abnormal behaviors

3) Support the Special Investigation Unit's (SIU) objectives by delivering timely, accurate and well‑documented investigation findings in accordance with governance, regulatory and confidentiality requirements

4) Collaborate closely with Team Lead, SG Fraud stakeholders and claims operations to strengthen fraud detection capabilities, enhance risk indicators and improve investigation effectiveness

5) Contribute to the adoption and effective use of digital tools, claims analytics and AI‑enabled insights to improve investigation quality, prioritization and operational efficiency

• Perform end‑to‑end FWA investigations in accordance with established investigation frameworks, governance standards and confidentiality requirements

• Identify, analyze and assess suspicious or potentially fraudulent claims by reviewing claims documentation and interpreting transactional, behavioral and historical claims data

• Apply risk‑based investigation techniques to prioritize cases, balancing investigation depth, timeliness and potential financial or reputational impact

• Conduct claimant, provider or third‑party interviews where required, ensuring adherence to investigation protocols, professionalism and non‑tipping‑off principles

• Verify claim documentation and supporting records, identifying indicators of forged, altered or inconsistent information using structured review methods and available digital validation tools

• Prepare clear, accurate and well‑documented investigation findings, case notes and reports for review, escalation or submission to the SG Fraud team

• Utilize claims analytics, rule‑based detection outputs and AI‑enabled insights (where available) to support case assessment, pattern identification and investigation decision‑making

• Support the refinement of fraud indicators, red flags and detection rules by providing feedback based on investigation outcomes and observed fraud patterns

• Contribute to fraud trend monitoring by highlighting emerging fraud typologies, abnormal behaviors or systemic vulnerabilities observed during investigations

• Collaborate with Team Lead, claims operations, analytics and relevant stakeholders to ensure alignment on investigation priorities, case handling approaches and risk mitigation actions

• Participate in knowledge‑sharing activities, briefings or training sessions to enhance fraud awareness and investigation capability within the claims community

• Support claims processing activities during peak periods, surge volumes or contingency situations, while maintaining vigilance on fraud risks and adhering to quality and control standards