Claims Fraud Analyst

Zurich Insurance Company Ltd.•Toronto, ON

2d•CA$65,000 - CA$85,000•Hybrid

About The Position

Zurich Canada is seeking a Claims Fraud Analyst to join the Data, Analytics & Artificial Intelligence team. This role will support Claims and Fraud partners by strengthening Zurich Canada’s ability to identify potential claims fraud, leakage, unusual patterns, and emerging risk indicators through data, analytics, and business insight. The successful candidate will collaborate with Claims, Special Investigations Unit (SIU), Technology, and analytics teams to review claims data, develop fraud indicators, validate trends, and translate findings into clear recommendations for better claims outcomes. This position offers a unique opportunity to combine claims knowledge, analytical thinking, and investigative curiosity to protect Zurich, its customers, and the integrity of the claims process. Zurich Canada utilizes AI-enabled tools in its recruitment process, but all hiring decisions are made by qualified professionals. The role follows a hybrid work model requiring in-person presence, which may include office time or market-facing engagements.

Requirements

Bachelors Degree and 3 or more years of experience in the Statistical Analysis area OR High School Diploma or Equivalent and 5 or more years of experience in the Statistical Analysis area.

Nice To Haves

Bachelor’s Degree and 2+ years of experience in claims, fraud, analytics, business intelligence, investigations, insurance operations, or a related field.
Strong analytical skills with the ability to interpret data, identify patterns, and connect insights to business actions.
Experience working with claims data, operational data, payment data, or other complex business datasets.
Strong communication skills with the ability to explain findings clearly to both technical and non-technical audiences.
Strong attention to detail, curiosity, sound judgment, and ability to handle confidential information appropriately.
Insurance claims, fraud, special investigation, or claims analytics experience.
Experience with Power BI, SQL, Databricks, Python, or similar analytics tools.
Experience analyzing claims payments, vendor patterns, recoveries, leakage, expenses, or fraud indicators.
Understanding of claims processes, claim systems, policy information, and fraud investigation workflows.
Experience building dashboards, recurring reports, data quality checks, or analytical summaries.
Knowledge of predictive analytics, anomaly detection, machine learning, or AI-enabled fraud detection is an asset.
Ability to work independently, manage multiple priorities, and build trusted relationships across business and technical teams.

Responsibilities

Analyze claims data to identify potential fraud patterns, unusual activity, leakage, overpayments, and other risk indicators.
Partner with Claims and SIU teams to support investigation prioritization, case reviews, and indicator refinement.
Review historical fraud cases and pending claims to identify recurring themes, emerging trends, and opportunities to improve detection.
Develop dashboards, reports, and analysis that help business partners understand fraud trends, payment patterns, vendor activity, and claim behaviours.
Support the design, testing, and monitoring of fraud indicators, rules, models, and alerts in partnership with data and technology teams.
Conduct deep-dive analysis on claim payments, payees, vendors, body shops, service providers, recoveries, and claims expenses.
Validate data quality, definitions, and business rules to help ensure fraud insights are accurate, explainable, and actionable.
Prepare clear summaries, recommendations, and presentations for Claims, SIU, and leadership stakeholders.
Collaborate with cross-functional teams to improve data access, reporting consistency, and the responsible use of analytics in fraud detection.
Stay current on emerging fraud trends, analytical techniques, and opportunities to use data and AI-enabled capabilities responsibly.