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Claims Fraud Investigator

3 months ago

Bournemouth, United Kingdom Vitality Full time

**About The Role**:
Hybrid role - 2 days a week in the office, 3 days a week at home. This role can be based either from Bournemouth or Stockport.

**Overall Job Purpose**

The Claims Fraud Investigator will be responsible for conducting investigations to a criminal standard for allegations of principally claims fraud, in addition but not limited to Broker and Distribution fraud where links are identified or the Financial Crime Team caseload requires.

**Accountabilities**
- Work closely with the CFM in investigating allegations of all types of Claims Fraud.
- Logging and setting up new referrals - ensuring robust records are kept for a sound audit trail.
- Creating and maintaining case files in accordance to relevant legislation and company policies.
- Drafting and producing MG11 statements and associated exhibits in accordance with current legislation.
- Take ownership of allocated Financial Crime investigations, projects or tasks as required.
- Produce Investigation reports with evidence and recommendations to the Financial Crime Committee (FFC).
- Maintain the database, dashboard, monthly reports as and when required.
- Liaise and work closely with existing financial crime functions, Claims Teams, Medical Underwriting, IT, Risk and Compliance within the Group
- Maintain relationships with external key bodies in relation to fraud, AML bribery and corruption
- Represent Vitality at relevant fraud forums/ Groups to enhance fraud prevention and detection.

**Skills Required**:

- 24 months claims experience
- Experience in managing fraudulent claims and business risk.
- Financial services sector experience.
- General office and stakeholder management experience.
- Excellent relationship management skills
- Excellent communication skills both oral and written
- Have an evidential strategic and tactical approach
- Strong client/ stakeholder management focus
- Competent and analytically minded

**About Us**:
Vitality is an award-winning, dynamic and vibrant financial services provider, with a ground-breaking vision for the future, where individuals are enabled to succeed and are rewarded and recognised for their contribution to our business. We’re the UK insurer and investment provider that rewards people for positive lifestyle choices - a key element of our Shared-value model. With 1.4m UK members and more than 25m globally, we’re out to make the world a healthier, happier place. This applies as much to our people as it does to our members.

Working for Vitality, you'll experience an exciting mix of creativity and innovation, within a framework of challenging objectives and a passion for delivering the best. We think work should be fun and sociable, and we want our people to get the most out of every day. Our people are chosen for their skills, knowledge, enthusiasm and attitude but above all, their belief that anything can be achieved. Wherever possible, we will consider a variety of working options to suit your lifestyle, whether that be hybrid home/office working, flexible working and part or full time employment. It’s what we call offering shared values, because a healthy happy team is good for us, good for our members and good for you.

Find out why people love being part of the Vitality Team