Counter Fraud Injury Claims Handler

RSA Insurance
Dublin City Centre
18 Sep 2018
17 Oct 2018
Job role
Counter Fraud Claims Handler What this job is really like: Jobs like this involve identifying and handling suspected fraud cases. You will use agreed claims processes to achieve successful outcomes in line with the business objectives for our Counter Fraud Strategy. You will spend the majority of your time reviewing and assessing claims, liaising with customers, Investigators and Solicitors to carry out detailed inquiries & applying your knowledge & experience to progress these cases to a successful conclusion. You will provide ongoing support, advice and guidance to the operational teams, helping to refine Best Practice Counter Fraud handling in RSA. You will be working to protect the policyholder and RSA. Our aim is to eliminate the spend on potentially fraudulent cases. You will be mostly desk-based dealing with customers, third parties & Solicitors on a one to one basis, although you will also work with other colleagues and be part of a team. You will have strong communication, negotiation, presentation and organisational skills. Jobholders are typically responsible for: Reviewing cases identified by NetReveal that are potentially fraudulent. Reviewing relevant classes of claims (case by case) and achieving optimum settlement or dismissal, within designated personal authority level, in line with established standards, procedures and guidance provided. Assessing claims against relevent criteria and experience to identify actual or potential issues and involving others as appropriate in order to minimise leakage and protect the interests of the business. Conducting File Reviews with our Solicitor Panel to ensure cases are progressed & all relevant tactics are applied in our Defence of these actions & that we have consistency of approach. Conducting or contributing to learning teams for both the Counter Fraud team & other operational teams to raise awareness & technical knowledge. Managing customer interactions in an efficient, courteous and timely manner in order to deliver high standards of customer satisfaction. Organising and using approved internal and/or external suppliers to ensure repair, replacement and supply of appropriate goods and services to customers. Helping and contributing towards the development of less experienced collegues to raise standards and expertise across the team. Leading, contributing to and co-operating with audits and reviews as required in order to support and enable the maintenance of an effective control environment. Providing proactive advice and guidance on the development of new and improved policy wordings to ensure policy documentation reflects claims experience and agreed risk appetite. Contributing to the identification of and research into new product and proposition development opportunities to ensure the claims components are feasible and appropriate to the target customer. This job will typically be measured with the following KPI's Quality and levels of service delivered Operational efficiency Achievement of personal goals relating to post clearance / settlement results / inactive case management Tracking of Counter Fraud Savings against Personal &Team Target for year Personal contribution to team productivity Application of Brand Beliefs Compliance with legal, regulatory and policy requirements Feedback from internal customers and colleagues The Candidate CIP qualified and must maintain CPD requirements Internal and external networking experience within the Technical community and beyond. In-depth experience of at least one line of business across the full width of customers, propositions and risk scenarios. RSA Insurance Ireland DAC and its affiliate companies consider applicants on the basis of qualifications and without regard to race, colour, religion, sex, national origin, age, marital or veteran status, sexual orientation, disability or any other legally protected status