As a Senior Fraud Investigator, you will be responsible for investigating, assessing, and finalising complex or suspicious insurance claims to detect and prevent fraudulent activity. This role also involves providing specialist support and advice to the Claims & Assessing teams, working collaboratively to maintain high standards of regulatory compliance.
Key Responsibilities:
- Conduct detailed investigations into complex or suspicious claims, including planning, interviewing, information collection, and analysis.
- Develop investigation plans, review evidence, and prepare detailed reports with recommendations.
- Engage external investigation services to gather additional information.
- Perform objective, fair, and timely investigations.
- Liaise with internal and external teams to review cases and make sound claim acceptance or rejection decisions based on evidence.
- Provide expert support on potentially fraudulent claims escalated to customer dispute resolution, including Ombudsman matters.
- Manage multiple cases effectively, meeting deadlines and maintaining high levels of customer service.
- Stay up to date with industry trends, fraud prevention techniques, and relevant legislation.
- Prepare comprehensive reports, maintain accurate records, and ensure thorough documentation of investigation processes.
- Proactively contribute as a team player or work autonomously to achieve compliance and investigation outcomes.
- Certificate IV in Financial Services or Certificate III in Investigative Services (highly regarded).
- Strong experience in conducting investigation interviews, particularly in the insurance industry.
- Solid understanding of insurance legislation and processes.
- Excellent verbal and written communication skills, with the ability to build rapport with clients from diverse backgrounds.
- Strong problem-solving, decision-making, negotiation, and conflict resolution skills.
- Proficiency in computer systems and administration tasks.
- Proven ability to manage time effectively and work independently in a fast-paced environment.
- We also welcome applicants who are ex-police services who have transferrable investigations experience.
- x 2 FTC opportunities (until September and November) Exact dates TBC.
- Beautiful Sunshine Coast office, moments from the beach and shopping center.
If you are a driven, motivated professional with experience in investigations, we’d love to hear from you! Please submit your resume or reach out to hannah.hawkanson@troocoo.com for more information.