Job Description
Conduct thorough investigations of insurance claims, including reviewing documents, evidence, and supporting data
Verify the authenticity and accuracy of claims by analyzing medical records, financial information, and other relevant documents
Perform field investigations when necessary, including interviews with claimants, witnesses, agents, or related parties
Identify potential fraud indicators and escalate suspicious cases for further action
Collaborate with internal teams (claims, underwriting, legal, and compliance) to ensure proper claim assessment
Prepare investigation reports with clear findings, conclusions, and recommendations
Maintain proper documentation and case records in line with company standards
Support in developing and improving fraud detection Qualifications: Bachelor’s degree in Insurance, Law, Business, Finance, or a related field
Minimum 1–3 years of experience in claims handling, investigation, audit, or a related role (insurance industry preferred)
Strong analytical and investigative skills
Knowledge of insurance claim processes, especially life or health insurance, is an advantage.