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Lead Specialist - Claims (Fraud, Waste & Abuse)

Company

AIA

Location

Cyberjaya, Malaysia

Type

Full time

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

Sound like you? Then read on.

About the Role

Assess outpatient and inpatient hospitalization claims from Group policyholders as per stipulated benchmarks and requirements.
  • Perform end‑to‑end FWA investigationsin accordance with established investigation frameworks, governance standards and confidentiality requirements

  • Identify, analyze and assess suspicious or potentially fraudulent claimsby reviewing claims documentation and interpreting transactional, behavioral and historical claims data

  • Apply risk‑based investigation techniques to prioritize cases, balancing investigation depth, timeliness and potential financial or reputational impact

  • Conduct claimant, provider or third‑party interviews where required, ensuring adherence to investigation protocols, professionalism and no...

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