Manager - Centralized Fraud Investigation Cell - Insurance Business (5-8 yrs)

About the Role:

- This role is pivotal in ensuring the integrity of our operations.

- As a Manager - CFIC, you will be responsible for independently managing and executing in-depth investigations of cases and incidents.

- Your responsibilities will include investigating complaint cases, preparing detailed reports, and coordinating with various teams to resolve issues effectively.

- Additionally, you will be involved in data analysis, report generation, and presentations to provide valuable insights.

Key Responsibilities:

Case Investigation:

- Conduct thorough investigations of complaint cases, policy lapses, and other relevant incidents.

- Collect and analyze evidence to identify root causes and potential systemic issues.

- Conduct fact-finding and verification processes.

Report Preparation:

- Prepare comprehensive and accurate investigation reports, detailing findings, conclusions, and recommendations.

- Ensure timely submission of reports to relevant stakeholders.

Departmental Coordination:

- Collaborate effectively with regional teams, field investigators, and other departments to facilitate smooth investigations and resolution of issues.

- Coordinate with legal and compliance teams as required.

Vendor Interaction:

- Manage external vendors and service providers involved in the investigation process.

- Oversee vendor performance and ensure adherence to quality standards.

- MIS, Analytics, and Presentation:

- Develop and maintain key performance indicators (KPIs) to track performance and identify trends.

- Analyze data to identify potential risks and opportunities for improvement.

- Prepare insightful presentations to communicate findings to senior management.

Required Skills and Qualifications:

- Domain Expertise: Strong understanding of the insurance industry, products, and regulatory framework.

- Investigation Skills: Proven ability to conduct thorough and objective investigations.

- Analytical Skills: Strong analytical skills to identify patterns, trends, and root causes.

- Problem-Solving: Excellent problem-solving and decision-making abilities.

- Communication Skills: Effective communication skills, both written and verbal.

- Interpersonal Skills: Strong interpersonal skills to build and maintain relationships with stakeholders at all levels.

- Technical Skills: Proficiency in MS Office (Excel, PowerPoint, Word), data analysis tools, and investigation software.

- Regulatory Knowledge: Understanding of relevant regulatory guidelines and compliance requirements