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Claims fraud & leakage manager - lisboa

Setúbal
Europ Assistance
Anunciada dia 5 março
Descrição

Europ Assistance, part of the Generali Group and a market leader in assistance services in Portugal—focused on travel and automotive assistance—has in recent years expanded into new business lines such as medical assistance and home & family services. Supporting customers through all stages of life is our goal and the essence of our new brand signature: you live we care.We are seeking a Claims Fraud & Leakage Manager to play a key strategic role in driving technical quality, fraud prevention, and leakage control across all lines of business. This position will act as the central technical authority for fraud risk management, claims governance, and operational excellence, leading initiatives that directly enhance efficiency, accuracy, and profitability.Key Responsibilities- Lead and develop the Claims Fraud & Leakage team, ensuring robust technical oversight of claims handling with a strong focus on fraud detection, fraud risk governance, and leakage control. - Ensure the Operations and Claims areas have the processes, tools, analytics, and resources required to effectively identify, prevent, and mitigate fraud risk. - Define, formalize, and implement fraud governance models, guidelines, detection frameworks, and training programmes. - Represent the local team in meetings with Regional and Group stakeholders, securing alignment on objectives, technical standards, and strategic initiatives. - Promote and drive local fraud prevention and detection initiatives, ensuring continuous enhancement of fraud controls. - Organize and coordinate Claims File Reviews and other audits focused on leakage identification and technical accuracy. - Design, implement, and monitor Action Plans to continuously improve fraud and leakage performance indicators. - Analyse KPIs and claims performance data to identify trends, emerging risks, and opportunities for corrective or preventive actions. - Collaborate transversally with Operations, Claims, Underwriting, Sales, Risk, Compliance, and other key business areas to reinforce a strong fraud prevention culture. - Oversee compliance with Ex Gratia payment protocols, the correct setting of reserves for high‐value claims, and proper classification of exceptional events.Profile & Experience- Proven and substantial experience in insurance claims fraud management, leakage control, and technical excellence within the insurance sector. - Demonstrated experience in leading and developing teams. - Strong strategic mindset and ability to influence cross‐functional stakeholders. - High analytical capabilities, strong organizational skills, and solid experience in project management. - Excellent communication, negotiation, and relationship‐building skills. - Portuguese. Fluency in English.What can we offer you?- Permanent contract. - Integration into a high‐performing team with stimulating and challenging work. - 35‐hour working week. - Hybrid working model. - Health and life insurance. - Location: Sete Rios, Lisbon—on‐site days combined with remote working days.At Europ Assistance, we offer continuous opportunities for development and growth. Innovation through new services and the use of information and communication technologies is one of our strategic pillars. Social responsibility and inclusion are core commitments, with various initiatives positioning us as a socially responsible company, both internally and externally.

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