Fraud Analyst - Mawista - Allianz - Cairo

Job description

Job Overview:

The Fraud Analyst role plays a key part in our global claims cost containment, quality & customer experience strategy. The ideal candidate will have an inquisitive mind and be focused on ensuring we prevent fraudulent activity/ waste and abuse at all stages of the claim journey.

The role requires the ability to multitask across numerous disciplines within the global claims department, and is ideally suited to a strong self-starter with excellent time management skills and a desire to develop within the organization

What you will do:

Responsibilities will include, but are not limited to, the following:

Handling of telephone and written complaints according to the professional decisions of the specialized department and, if necessary, in critical
Escalations (including social media) in coordination with relevant units.
Conducting fraud investigations and processing according to specified standards.
Quality assurance of claims processing through leakage checks (Open File Review & Close File Review).
Development and implementation of measures for complaint prevention.
Ensuring compliance with company standards in complaint handling, including reporting and analysis.
Identification and processing of recourse cases.Support and implementation of BaFin and company policies.
Systematic documentation and analysis of complaints for root cause identification and measure development.
Participation in projects and forums to improve complaint management.
Conducting and analyzing fraud investigations, supported by IT-based data analysis.
Preparation and delivery of training sessions and creation of reports in the area of leakage and fraud management.
Implementation and enforcement of policies for the prevention of leakage, recourse, fraud, and complaints.
Collaboration with specialized departments and headquarters for the strategic development of measures.

What you bring:

To be successful in this position you will need to have the following skills/ experience:

At least 2 years’ experience in a Health Insurance environment
Experience in analysing and assessing medical claims of high values and complexities
Ability to communicate effectively with various audiences and all levels of the organisation
Professional experience in direct customer contact, ideally in health insurance and fraud management; experience in investigation services is advantageous
Competence in de-escalation and complaint management, along with a confident demeanor
Strong communication skills, decision-making ability, and excellent verbal expression
High customer orientation, initiative, and independence
Fluent German and business-proficient English skills
Strong knowledge of Excel and PowerPoint

What we offer:

Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.

We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.

Offers “Allianz”

Job description