Sr. Specialist - Insurance Investigation

Allianz
Bangkok
Workplace: OnsiteFull timeFunction: Insurance & ActuarialExperience: 3-5 yearsEducation: bachelorsSkills: ["Analytical thinking","Problem-solving","Decision-making","Integrity","Confidentiality"]

Investigate life and health insurance applications, claims, and allegations of fraud, misconduct, and mis-selling to protect customers and the business. Conduct fact-finding, interviews, and evidence evaluation, including coordination with hospitals and medical providers. Prepare detailed investigation reports with findings and recommendations, escalate high-risk cases, and ensure investigations meet service standards, timelines, and approved budgets while partnering across Claims, Underwriting, Legal, Compliance, and Fraud Management.

Loading

Loading job details...

Preparing the role view and application actions.

FursaFursa
Allianz
Allianz
1 day ago

Sr. Specialist - Insurance Investigation

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Investigate life and health insurance applications, claims, and allegations of fraud, misconduct, and mis-selling to protect customers and the business. Conduct fact-finding, interviews, and evidence evaluation, including coordination with hospitals and medical providers. Prepare detailed investigation reports with findings and recommendations, escalate high-risk cases, and ensure investigations meet service standards, timelines, and approved budgets while partnering across Claims, Underwriting, Legal, Compliance, and Fraud Management.
Location: Bangkok
Workplace: Onsite
Employment Type: Full time
Job Function: Insurance & Actuarial
Seniority: Mid level

Key Responsibilities

  • •Lead and manage investigations related to underwriting and insurance applications.
  • •Develop investigation strategies, allocate resources, and ensure investigations meet service standards, timelines, and budgets.
  • •Conduct detailed fact-finding, including gathering information about medical history, occupation, lifestyle, and risk factors.
  • •Investigate high-risk/suspicious claims and provide recommendations to support fair and accurate claim decisions.
  • •Investigate fraud, misconduct, and mis-selling allegations; gather evidence, coordinate with stakeholders/law enforcement when needed, and prepare reports with corrective actions recommendations.

Key Requirements

  • •Bachelor’s degree or higher in Law, Business Administration, Nursing, Medical Technology, Health Sciences, or related fields.
  • •3-5 years of experience in insurance investigation, claims management, underwriting, internal audit, fraud investigation, or compliance/risk management in insurance.
  • •Strong knowledge of insurance products, claims assessment, underwriting practices, and fraud detection techniques.
  • •Experience conducting interviews, field investigations, and evaluating evidence for investigations.
  • •Ability to prepare professional investigation reports and communicate findings effectively with integrity and confidentiality.
Experience:3-5 yearsInsuranceFraud investigationClaims management
Education:Bachelor's
Skills:Analytical thinkingProblem-solvingDecision-makingIntegrityConfidentiality
Tech Stack:Power BITableauSQLPythonChatGPTCoPilot365

Company Brief

Allianz
Global insurance and financial services group offering property-casualty insurance, life and health insurance, asset management, and corporate risk solutions to individuals, businesses, and institutions across more than 70 countries.
Industry: Insurance
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: Munich, Germany
Founded: 1890
WebsiteLinkedIn