Claims Fraud Investigator Job at AIG, Atlanta, GA

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  • AIG
  • Atlanta, GA

Job Description

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Fraud Investigator to play your part in that transformation. It's an opportunity to grow your skills and experience as a valued member of the team.

Make your mark in Fraud Investigation

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.

How you will create an impact

The North Americas Fraud and Recovery TPA Analyst will work closely with the Global F&R TPA Lead as well as the NAM Claims TPA Governance team. The role will develop, roll out and maintain a standard procedure for TPA reviews in North Americas that either refer or carry out Fraud and Recovery activities on behalf of AIG. The role will work very closely with the International F&R team as well as NAM Claims TPA team to ensure consistency in procedures and interaction with TPAs. It is a role that covers many states, countries and jurisdictions, so the candidate would need to manage stakeholders across different territories and cultures. A strong understanding of Fraud and Recovery services throughout the lifecycle of a claim would be required. A good understanding of different line of businesses within claims, including high level fraud and recovery indicators is essential. The role would align closely to the Claims TPA and Governance team and currently has no managerial responsibilities.

Key Responsibilities:

· Understand the NAM TPA landscape, specifically those carrying out Recovery and Fraud work items.

· Define key metrics and key performance indicators to track and review the TPAs against for Fraud and Recovery work items.

· Take ownership and responsibility of the ongoing TPA reviews in North America and work with the International team to build a repeatable process tailored to the regions.

· Carry out ongoing TPA quality, performance and expense control reviews across the NAM TPA landscape.

· Report back to Fraud & Recovery COE, as well as Claims Leadership on progress, any risks/issues and next steps on a regular basis.

· Create and maintain a detailed TPA tracker

· Be proactive in identifying areas of improvement or anticipating work that needs to be completed.

· Define contractual requirements and expectations with new TPAs to support the Fraud & Recovery TPA goals.

· Support in the wider execution of the Global and International strategic initiatives to ensure we embed change both within our organization and also with our partner organizations.

· Develop strong stakeholder engagement and communication with a focus on collaboration across the whole of the operations team and wider claims team.

· Support effective claims business reporting including monthly and quarterly business reviews.

What you'll need to succeed

  • The successful candidate will have strong organizational skills, an ability to understand and comprehend new topics quickly, and a pro-active self starter.
  • Experience with Vendor and TPA management and review
  • A candidate who is comfortable handling large amounts of data and reviewing the detail.
  • A candidate who is comfortable with having vendor/customer discussions, including proving feedback and performance conversations.
  • A good all rounder who is willing to learn new skills and take on challenges as they arise
  • The individual would also need to demonstrate a strong understanding of the claims, recovery and fraud process
  • 5+ years of experience within TPA/Vendor management ideally in insurance
  • Understanding of the typical/standard Fraud and Recovery KPIs or indicators
  • Strong administration skills and some examples of where project delivery, has been completed.
  • Analytical experience to see trends and insights.
  • Excellent communication skills, for both external and internal stakeholders
  • The ability to understand and ask questions around business issues.
  • Experience of project delivery or consulting experience preferred.
  • Proactive self starter
  • Ability to synthesis
  • Good attention to detail
  • Experience with Access, Word, Excel, PowerPoint, and SharePoint

Ready to take your career to the next level? We would love to hear from you.

#LI-NH1 #claimsprofessionals #FraudInvestigation #FraudInvestigator

Enjoy benefits that take care of what matters

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what's most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of belonging

We're committed to creating a culture that truly respects and celebrates each other's talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity of our people is one of AIG's greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to candidatecare@aig.com .

Functional Area:

CL - Claims

Estimated Travel Percentage (%): Up to 25%

Relocation Provided: No

AIG Claims, Inc.

Job Tags

Relocation, Flexible hours,

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