Manager - Fraud

Job description

The ‘Fraud Management Coordinator’ is placed in the Business Unit locally within the Fraud Management COE under the Operations Steering and Transformation function in Operations.

This position reports directly to the Regional Head (Lead) of Fraud Management (of the concerned region of the Business Unit (BU)).

The role is responsible for safeguarding the Business Unit against fraudulent activities across the Lines of Businesses (LoBs).

In order to ensure the local connect (with local fraud trends, culture, customer behavior, liaising with local law enforcement, the fellow insurer etc.) and also for the disciplinary purpose, this position will also report into a senior functionary (Manager) locally at the BU (it could be a Head of LoB / Head of Ops / Head of Ops Support / or the Country Manager)

 

 

DUTIES AND RESPONSIBILITIES:

 

·  Strategy Development:
·  Drive the ‘Zero Tolerance’ policy across the BUs and the GCCs in the regions allocated. Must leverage all available means of communication to reinforce the same.
·  Always ensure consistent interpretation of the Fraud Management Functional Rules, its implementation and adherence to the key principles.
·  Assessment of the BU on fraud maturity. Learn the remedial measures required and continuously drive actions to enhance the maturity.
·  Formulate and implement comprehensive fraud prevention and detection strategies in the BU and ensure the alignment of the same with the organizational targets of Allianz Partners.

 

·  Organization :
·  If there is a GCC/other Processing Hub supporting the Fraud Management in the BU (depending on the structure finalized centrally in the Fraud Management COE for the BU), extend full support to the concerned GCC’s HR to hire on time and position the right candidates (employees) at the right place to extend the fraud management coverage to all LoBs in the BUs.
·  Create the expertise in the BU team and the GCC (if applicable) based on the Line of Business (LoB)
·  Consult with Manager and the Leadership seeking support on the fulfilment and learn to economize on resources and work to optimize the performance out of the team available.
·  Align the GCC (supporting the BU- as applicable) and help Manager manage the Fraud Management team at the GCC. Ensure fully clarity on distribution of roles and responsibilities and ‘who does what’ locally (at BU) and regionally (at GCC)

 

·  Processes :
·  Ensure timely processing and the investigation of the suspected fraud alerts generated from several sources (referrals from claim handlers, the technology tool, other internal referrals and the external referrals)
·  After the completion of the fraud investigation on alerts, close-looping each case with the Claims Team based on the investigation outcome (for example- the denials of claims on the proven frauds and further processing on the false alerts)
·  Ensure that a properly documented, correct and a stepwise process of fraud referrals (from the claim handlers) is implemented and understood well on the operations floor.
·  Ensure the execution of LoB wise Standard Operating Procedures (SOP) in the BU.
·  Collaborate closely with other departments of Allianz Partners to integrate fraud prevention measures into daily operations.
·  A rhythm is maintained to train all the new joiners in the BU through a well document training material.
·  A regular and a periodic rhythm must be maintained in the BU to train the claims team on the potential fraud red flags and the prevailing fraud trends.
·  Follow the operating rhythm and lead the campaign to spread fraud awareness in the BU.
·  A separate fraud referral process and the SOP must be documented and implemented for the technology solution used (e.g., GAFS for Travel- if applicable) for fraud detection.
·  Take the lead in the process of optimizing the business rules and the fraud red flags keeping in view the prevailing fraud trends.
·  Leverage the in-house Lead-Data Analytics in the Fraud Management COE Organization to identify the current and the emerging fraud patterns, anomalies and potential indicators of fraudulent activities and take timely remedial actions.
·  Compliance : Ensure that fraud prevention practices align with industry regulations, legal requirements, and internal policies of Allianz Partners.
·  Create Service Level Agreements (SLAs) on key KPIs (e.g., the TAT of triage and the fraud investigation, fraud referral rate, proven fraud rate etc.) and ensure adherence to the same.
·  Monitor the performance through incisive KPIs. Ensure the execution of early warning signals (EWS) to catch frauds at an early stage.

 

·  Technology:
·  Fraud Detection Systems : Support the implementation and management of advanced technology-based fraud detection systems (e.g., GAFS for Travel)- as applicable.
·  Efforts must be undertaken to leverage the available internal systems and the means to create an alternative automated solution (e.g., the BU’s legacy system / One BI- Micro Strategy / SQL query-based reports etc.) to independently generate fraud alerts.

 

·  People
·  If there is a GCC/other Processing Hub supporting the Fraud Management in the BU (depending on the structure finalized centrally in the Fraud Management COE for the BU), extend full support in ensuring the training of the new hires in the fraud management team at the GCC on the fraud management in the BU and also on the BU’s LoBs and the overall claims management processes and the systems applicable.
·  As a part of executing the Fraud Management COE in the BU and with support from the Manager (Regional Head (Lead), ensure clear segregation of duties amongst the fraud management teams bases locally (in the BU) and regionally (if applicable- in the GCC to support the BU). There must be clear definition of ‘Who does What’ locally (at BU), regionally (at GCC) and centrally (at Global office).
·  A regular rhythm must be maintained to train all new joiners in the company (at the on-boarding stage), the claims team (especially the claim handlers) and the upskilling of the fraud management teams at the BU and the GCC.
·  Must own the training/upskilling of self and the fraud management team in the BU and the GCC (if applicable) on the emerging fraud trends and the workable solutions.
·  Must follow an operating rhythm to functionally review the performance of the BU (including of GCC supporting the BU) with the Manager (the Regional Head /Lead).
·  With support from the Manager manage the team at GCC (supporting the BU) Clearly ensuring the expectations on the fraud management tasks expected out of them (GCC).

 

·  Reporting :
·  Ensure, a proper operating rhythm is followed regularly to report the defined Fraud KPIs (refer to Group Standards), as required per the underlying process.
·  Work to automate (on best effort basis and to the extent possible) the reporting of KPIs (work with peers (Lead Data Analytics) in the Fraud Management COE
·  Ensure, the Fraud KPIs must be incisive and effective to rightly reflect the performance the BU
·  Ensure the publishing of the proper dashboards (standard template followed centrally) to stakeholders on the performance of the BU.

 

·  Other responsibilities:
·  Incident Response: Lead and guide the investigation into the sensitive /high value suspected fraud cases in the locations, coordinating with law enforcement and legal teams, as necessary.
·  Legal Collaboration: Collaborate with legal teams to ensure proper documentation and adherence to legal requirements in fraud-related matters, as necessary and as and when required.
·  Vendor Management: Oversee relationships with external vendors (as applicable) providing fraud prevention services or technologies. Group policy and guidelines must be followed in terms of the due diligence and the overall criteria around the vendor selection.
·  Stakeholder management: Engage the senior leadership and the stakeholders in the BU and ensure adequate visibility of the function / team through timely and appropriate communication to them. Be the voice of the function in the BU and in the senior leadership forums in the BU.

.

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us. 
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Great to have you on board. Let's care for tomorrow.