The primary responsibilities of the Triage Analyst are:|
- To collect basic information related to all manual and automatic referrals
- To conduct a thorough analysis of all incoming suspicious claims referrals.
- To make the determination if referrals meet established requirements, and should be sent to the investigative team.
- To conduct segmentation of accepted referrals by type of investigation required and complexity.
- To provide coaching and feeback to adjusting and claims management personnel on the quality of referrals.
- To track metrics and evaluate trends in metrics to be shared with senior management.
- To evaluate quality of automated referrals and propose adjustments to critera to improve quality of those referrals.
Technical skills and Abilities:
- Ability to drive anti-fraud program initiatives for claims operations within assigned region of responsibility.
- Ability to interact with and brief regional management
- Exceptional verbal and written communication skills
- Thorough understanding of insurance and claims processes.
- Strong working knowledge of insurance or fraud investigations (multi-lines a plus)
- Experience with claims management, case managment and desk investigative search tools.
American International Group - 16 months ago
Even to this day American International Group (AIG) is one of the world's largest insurance firms. While it held the spotlight...