Technical Counter Fraud Claims Executive Job Description

Handling claims involving personal injury related to serious insurance fraud is the main responsibility of a Technical Counter Fraud Claims Executive.

Primary Objectives:

• This kind of job requires excellent interpersonal skills and the ability to lead and coach people.
• The Technical Counter Fraud Claims Executive is responsible for ensuring that fraud is effectively identified and that risks are mitigated.
• The Technical Counter Fraud Claims Executive must demonstrate a successful background in managing Counter Fraud measures.

The primary responsibility of a Technical Counter Fraud Claims Executive is to coordinate, implement and develop the company’s strategy on fraud management. Both pre- and post- litigation, a Technical Counter Fraud Claims Executive handles. The Technical Counter Fraud Claims Executive decides on issues involving policy liabilities and legal liabilities and authorizes checks within the company guidelines. The Technical Counter Fraud Claims Executive must be capable with knowledge and skills in making sure that identification of fraud or any potential fraud remains a priority as the Technical Counter Fraud Claims Executive works closely with staff from Audit and Training.

The Technical Counter Fraud Claims Executive must possess knowledge regarding counter- fraud strategies. The Technical Counter Fraud Claims Executive must comply with the regulatory and the internal system controls. The Technical Counter Fraud Claims Executive must also be able to implement anti- fraud procedures. He handles claims in a manner that is cost- effective following the company guidelines and procedures. The Technical Counter Fraud Claims Executive must be able to assist with the training of those team members who are less experienced. The work for the Technical Counter Fraud Claims Executive makes strong analytical skills together with MI skills a must.

Technical Counter Fraud Claims Executives will work closely with some other insurers as well as external bodies like Insurance Fraud Investigators Group and Government agencies to combat the threats currently dealt with. Furthermore, the Technical Counter Fraud Claims Executive undertakes the important pre- visit inquiries by coordinating with the police, with the policy holders and even with third parties if necessary. After the visit is done, the Technical Counter Fraud Claims Executive handle claims up to its completion or rejection.

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