Senior Associate - Claims (fraud, Waste & Abuse)

AIA Australia

Fraud waste and abuse investigation experience
Claims data analysis and pattern recognition
Risk-based investigation techniques
The role involves conducting structured, risk-based fraud investigations to support effective detection and prevention strategies

Job Summary

  • The role involves conducting structured, risk-based fraud investigations to support effective detection and prevention strategies.
  • Candidates will analyze claims and behavioral data to identify suspicious patterns while adhering to strict governance and confidentiality requirements.
  • The position offers opportunities to collaborate with stakeholders and utilize AI-enabled insights to improve investigation quality and operational efficiency.

Matching Summary

The role involves conducting structured, risk-based fraud investigations to support effective detection and prevention strategies.

Skills & Requirements

Must-have

  • Fraud waste and abuse investigation experience
  • Claims data analysis and pattern recognition
  • Risk-based investigation techniques
  • Interviewing claimants and providers
  • Documentation of investigation findings

Nice-to-have

  • Experience with digital tools and AI insights
  • Knowledge of emerging fraud typologies
  • Collaboration with cross-functional teams
  • Ability to work during peak periods
  • Commitment to professional development

Key Requirements

  • End-to-end FWA investigation capability
  • Proficiency in claims documentation review
  • Understanding of regulatory compliance standards

Work Rights

Not specified

Tailored Resume

Cover Letter