General Counsel (Investigations, Principal)
Salary Market Aligned
Location Kuala LumpurFULL_TIME
Consultant Kimmy Khoo
Job Ref 1833900/001
Date posted 01 August 2022kuala-lumpur legal/other 2022-08-01 2022-09-30 legal Kuala Lumpur MY Robert Walters https://www.robertwalters.com.my https://www.robertwalters.com.my/content/dam/robert-walters/global/images/logos/web-logos/square-logo.png
Due to on-going and excellent success and developments, this leading insurance company is looking for a high-calibre for an General Counsel (Investigations, Principal) job to lead medical fraud investigations.
About the General Counsel (Investigations, Principal) Role:
As the co-lead in the General Counsel division, you will assist in all medical fraud related investigations to ensure high level of governance and is the second point of contact, handling suspicious or fraudulent medical claims pertaining to the business operations.
- Handle major/priority medical fraud investigations cases
- Provide guidance to the medical fraud claims team in relation to detection and prevention of fraudulent medical claims and corrective measures to be taken to reduce incidents
- Conduct objective, fair, thorough, unbiased, and timely investigations into allegations of medical fraud committed by clients against the company
- Review and research medical investigation evidence/documents to analyse the overall fact pattern of medical claims and data and provide the necessary recommendations for improvement
- Prepare, coordinate, and lead field assignments for medical fraud investigations to obtain relevant evidence and information
- Coordinate with the authorities to provide strategies and use law enforcement resources to ensure that appropriate action is taken against the medical fraud perpetrators
- Lead the development of policies and procedures where necessary to prevent medical fraud activities and to recover any incurred losses
- Identify the weakness of current control processes and recommend enhancements
- Collaborate investigation with appropriate business partners and authorities
- Conduct, manage and assist investigations into financial crime and security breaches as requested.
- Timely completion of fraud investigations supported by evidence and quality reporting
- Keep exposure to intermediary medical fraud financial exposure at a minimum level
- Identify trends through investigation outcomes
- Appear during court hearings to testify as witnesses and present evidence from the investigation to support the testimony
- Train fraud investigation personnel and other claims personnel to ensure knowledge sharing and upskilling of the teams across the business and entities
- Provide timely and quality reporting to the relevant management committees (including the market conduct committee, risk committees etc.) and acting on feedback /follow-up actions arising from such meetings/committees
- Timely regulatory and group reporting
To succeed in this General Counsel (Investigations, Principal) role, you need to understand the nature of the business, have a flair for active listening and evidence gathering and excellent communication skills, given the engagement required with various external stakeholders such as regulators, enforcement authorities, government departments and more.
- Bachelor's Degree in Law/ Legal from a reputable university
- At least eight years of working experience in legal related field or equivalent
- Sound knowledge of relevant laws and regulations
The successful candidate will join a company whose expertise has made them the leader in their field. This reputable organisation offers a great working environment in a dynamic and well-designed office in Kuala Lumpur.
If you have solid experience dealing with medico-legal/medical fraud and is naturally inquisitive and curious, this General Counsel (Investigations, Principal) role is an excellent opportunity to work with an industry leader that is constantly innovating and growing its business.
Click Apply now or email your CV to email@example.com today to discuss this new opportunity.
Do note that we will only be in touch if your application is shortlisted.
Agensi Pekerjaan Robert Walters Sdn Bhd
(formerly known as Robert Walters Sdn Bhd)
Business Registration Number : 729828-T
Licence Number : JTKSM 423C
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