Quality Analyst - Claims Investigations
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Overall Purpose of the Role
- To provide quality assurance and technical oversight of claims investigation reports, review the quality and accuracy of investigations, and support the handling of complex investigations to ensure sound claims decisions, compliance with established procedures, and effective claims management.
Qualifications & Experience
- Bachelor’s Degree in Insurance, Business Administration, Risk Management, Criminology, Law, or a related field.
- Diploma in Insurance (AIIK) or equivalent.
- At least five (5) years’ experience in claims investigations, quality assurance, or a related insurance environment.
- Experience in reviewing and quality-checking investigation reports.
- Experience handling complex or high-value claims investigations will be an added advantage.
- Good understanding of insurance claims processes, fraud detection, investigation procedures, and regulatory requirements.
- Strong analytical, report writing, interviewing, and decision-making skills.
- Proficiency in Microsoft Office Suite.