Claims Fraud Consultant

What you'll do:

TPA Oversight & Relationship Management: Supervise and manage the Third Party Administrator, conduct case reviews and audits, identify leakage or process gaps, and maintain a strong, constructive working relationship

Technical Expertise & Complex Claims Support: Provide fraud expertise, supporting the UK Claims Manager with large or complex cases and presentations to reinsurers and internal stakeholders

Fraud Claims Handling & Team Development: Initially manage fraud claims directly, later supporting leadership as the team grows, and contribute to the design and delivery of technical training to strengthen fraud capability

Platform & System Development: Contribute to the development of the Global Claims Platform, shaping efficient processes and driving its evolution to become market-leading

Strategy, Governance & Compliance: Support the long-term fraud strategy, establish robust governance and performance frameworks, and ensure adherence to protocols and case strategies

Process Improvement & Escalation Management: Lead change initiatives to improve efficiency, digital adoption, and customer experience, while acting as the final escalation point for complex or high-value fraud cases.

What we’re looking for:

Market Knowledge: Proven experience in managing Claims Fraud, aware of current market strategies

Expert Level Technical Knowledge: A high level of technical competency, which can be demonstrated in case handling and through case discussion

Knowledge of Fraud Tools: A high level of knowledge of market-leading Fraud tools such as SIRA

Data Analysis: Ability to utilise data to interpret performance trends and translate insights into actionable commercial strategies

Stakeholder Management:  Highly effective communicator and influencer with strong influencing skills, capable of building credibility and managing relationships with both internal senior leaders and external partners.