The Recovery team at Gore Mutual is expanding! We are looking for exceptional talent in anti-fraud investigations for Gore Mutual.
Joining our team will provide you with a unique opportunity where you will be part of a brand new and impactful team, contributing to an evolving industry, and a company that is going through an exciting transformation.
We are on a new path called NEXT HORIZON
The insurance industry is changing at an exponential pace, driven by changing customer experience, climate change and technology. In response Gore Mutual is making bold moves to reposition our company as a purpose driven, digitally led national insurer. Next Horizon is our 10-year vision and strategy that sets a new path for our company.
Come and make your mark on our Next Horizon!
What will you do?
- Review files referred, composes and updates investigation strategy through life of file.
- Investigate or use vendors to determine if there is evidence of fraud by clients, third party claimants, suppliers, brokers or internal to Gore
- Review submitted documents for inconsistencies/other signs of fraud. Perform on-site investigations as required.
- Review and prioritize incoming referrals by amount incurred, complexity, visibility, potential risk to Gore, limitation date, other.
- Assist in the design and delivery of regular, customized fraud detection, investigation and avoidance training for claims handlers and underwriters.
- Ensure all investigations are carried out in a pro-active, professional manner and that Customer/Broker enquiries are responded to in a timely way.
- Regularly attend Industry training, CASIU events, IBC committees/other to maintain proficiency and ensure Gore is aware of the latest trends in Insurance Fraud.
- Design and assist in maintaining Gore Mutual Intelligence database from any/all open source material and direct knowledge of industry events.
What will you need to succeed?
- Minimum 10+ years in Insurance Claims Investigation, 5+ years in Major Case Investigation, and 5+ years in Training & Mentoring
- Minimum education: high school diploma, with a college diploma in the police foundations. University degree, and CIP, CFEI, CFE courses or designations is preferred
- Strong communication and collaboration skills
- Use of anti-fraud technology