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Investigate Manager

Job Description

Company Overview
Our Client is one of the largest life Insurance companies in the World looking for a talent for Investigate Manager position.

Job Description
This role is designed to monitor all investigation activities of the Requesting Division in order to operate smoothly daily in providing verification directions.
- Analyze the excellent and effective investigation plan, to help assess complaints quickly and accurately for customers and adhere to company strategies to ensure credibility.

- Be able to provide the response to inquiries and complaints related to claims from claimants, advisors, other departments that are relevant to the investigation.

- Proposing, initiating and managing operations of nationwide Investigate team to ensure Claims team’s activities smoothly executed in accordance with the Company principle and guidelines; monitoring quality and productivity of investigator staff to ensure fast and accurate assessment as Claims guidelines and cost efficiency

- Reviews internal manuals and may develop recommendations on management strategies. Develops, documents and executes claims management plans by identifying trends in cases.

- Appraises and approves benefit claims within prescribed approval limits

- Well managed and well planned for the travel costs of the investigations of the whole team

- Control and manage the Investigate Team for doing investigate in the claim cases need investigation. Always finding the most effective verification methods but must follow the law.

- Create strategies and methodologies for identification of fraud indicators.

- Manages litigated claims and appeals, instructs counsel on disposition. Acts as a technical resource and coaches investigators on complex claims decisions.

- Guide and train a team investigators of composed of many members

- Skilled and proactive working across functions such as Compliance, Legal, Complaint handling, Medical team, Underwriting, outsides:

- Co-operate with Legal department for seeking advice for complex cases that could lead to litigation. Co- operate with Compliance department for the fraud cases or suspected cases. Co-operate with Complaint handling department to handle complaints and respond enquiries that related to claims from clients, advisor, other departments. Co-operate Medical team for the case has medical aspects during investigation.

- Help feedback to Underwriting and Sales teams on patterns of claim frauds and investigation results, and help improve the field underwriting and NB Underwriting processes

- Build relationships across industries and industry bodies, to help in the investigation process

- Continuous improvisation of processes to shorten TAT, and improve claim experience
- Think of ways to bring technology (Speedy rules, Data Analytics and AI) to help detect frauds.

Requirements
- University graduated.
- Knowledge of law, medical, insurance and police.
- Relevant Working Experience: At least 8 years of experience in Investigate Claims field
- Have good knowledge of life insurance and well skills

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