Fraud Investigator

Who We Are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security. Who We Are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security. Get to know the business AIG is seeking a Fraud Investigator to join the Global Investigative Services ("GIS") team in our Iberia Cluster in Lisbon Office. As Fraud Investigator you will be responsible for all aspects of the investigation process, including the creation of investigation plans, identification and assignment of relevant enquiries, desk and field investigations and reporting of findings. As an investigator, you will support claims handlers in the processing of claims and use your knowledge and experience to ensure that the risk of insurance fraud and abuse is minimized for AIG. The Fraud Investigator is responsible for conducting fraud related investigations on claims which have been identified as having potentially fraudulent activity, as well as interacting externally with state and/or federal agencies during the litigation and prosecution of appropriate fraud activities. Being one of the main contacts for Country related stakeholders, the Fraud Investigator takes active presence in the day-to‐day office work, creating a fraud awareness environment and seek for continuous result improvement. About The Role What you need to know: The Fraud Investigator will have the following key competencies and responsibilities: Work closely with GIS team to execute investigations with a moderate level of supervision (relevant to the years of experience). Assist on fact finding and investigative interviews of key subjects. Prepare succinct interview memos summarizing the topics discussed, findings and other observations. Perform email reviews to identify evidence of fraud and to corroborate information. uncovered during the investigative process. Summarize and present the results of the investigations to management and stakeholders, highlighting relevant facts and insights; Draft reports detailing work performed and conclusions reached that require minimal editing and provide a clear message to ensure client understanding and suggestion for corrective action. Ability to concurrently work on multiple projects, participates in assignments in a team environment, and consistently meets deadlines. Possess strong analytical skills to identify audit risks, fraud risks, investigative concerns and appropriate testing or investigative procedures. Demonstrated ability to maintain the confidentiality of information and identities. Under moderate supervision, identifies and pursues fraud awareness at multiple Lines of Business and Products including related third parties who are wholly responsible or share liability for damages paid to claimants by AIG. Typical responsibilities include but are not limited to the following: Review assigned claim files to determine if fraud risk is feasible by investigating and evaluating issues according to a Best Practice/Procedural guidelines. Coordinate investigations with expert witnesses to review the adequacy of the investigation conducted by claims personnel. Corresponds with appropriate parties (experts, attorney's, claims professionals) in accordance with established procedures regarding claim information, notice/demand of related issues. Research, understand and apply state laws that relate to each file. Keeps management advised of legislative, regulatory, and legal developments which may have an impact on fraud related outcomes. Forecasts potential "fraud risk threshold", overview and update the drivers as needed. Provides customer service assistance to outside organizations and AIG Claim Operation management. Prepares for and attends mediations or pretrial sessions. Establishing and maintaining professional working relationships with insured's, claimants, witnesses, lawyers, corporate employees. Develop and maintain good relationships with internal clients. Identify, create, and complete fraud awareness training for various lines of business as requested by your manager and stakeholders. Measure and identify gaps in fraud controls and establish proceedings to ensure levels of fraud are brought to the desired level. Create awareness across all business for fraud related topics. Accurately identify and record all financial impact for cases worked in the fraud case management system. Assisting the Claims & Fraud management as appropriate in ensuring key deliverables and business objectives are met. Awareness of, and adherence to, GDPR regulations and local laws regarding techniques used for information gathering in countries where operating. Completing targeted claims reviews for all lines of business within AIG as assigned. This includes analysis, documentation of results and suggestions for improvement. Participates in training by providing information as a subject matter expert as requested. Support leadership team and stakeholder on result reporting. Engage, participate and develop the automated fraud controls, establishing best practices and creating measurable controls to ensure all metrics are within desired scope. Work in partnership with clients and colleagues to contribute to the AIG's success. What We're Looking For Proficiency in Portuguese is required, and a strong knowledge of Spanish and English is highly desired. B.S. / B.A. degree in Law, Criminology, Business Administration or other relevant degrees. Strong experience in corporate/financial investigations is desired. Strong knowledge of complex claims scenarios across all Lines of Business, including Accident & Health, Financial Lines, Casualty and Specialty. Ground experience in claim-related files, whether from expert, legal or another relevant claim's role. Possess knowledge of financial and operational controls, as well as an understanding of internal auditing standards, and risk‐assessment practices. Strong organizational skills, attention to detail and proven ability to effectively prioritize initiatives to meet expectations. Modern metric capacity, ensuring automated detection models are being accurately implemented. Proficient in MS Office: Excel, Word, Access & PowerPoint. Good verbal, written and presentation skills are essential. Ability to present complex and sensitive issues to different levels of senior management. Think in a creative and innovative manner. Demonstrated ability to manage and prioritize case load with limited supervision Demonstrated ability in time management and establishing priorities Willingness to overcome results and drive the necessary measure to ensure results are met. Advanced knowledge of civil justice systems Ability to organize data and write case investigative reports. Ability to alter workflow to create and pursue leads that would support a recovery case. Must demonstrate and maintain strong ethics. Willingness to travel: up to 25% annually. At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike. Enjoy Benefits That Take Care Of What Matters At AIG, our people are our greatest asset. We know how important it is to protect and invest in what's most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family. Reimagining insurance to make a bigger difference to the world American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever‐better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become. Welcome to a culture of inclusion We're committed to creating a culture that truly respects and celebrates each other's talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG's greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations. AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to Ver o e-mail no tdrct.com. Functional Area CL - Claims AIG Europe S.A. (Portugal branch) #J-18808-Ljbffr