Claims Governance and Fraud Data Analytic
location
Bangkok, Thailand
Job Function
Actuary
Salary
Negotiable
Industy
Insurun
Experience
-
Job ID
SBC-240130-007
About The Company

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Job Responsibilities

1. Fraud Data Analytic: • Analyze gap from claim data to see significant trigger of potential fraud by various indicators e.g. benefit, agent, channel, geography, hospital or treatment method etc. • Design forecasting model to determine clear-cut tolerance of fraud or clean claim. • Support requirement of project to find effective innovation of fraud detection. • Prepare fraud dashboard and presentation to update Head of Claim. • Prepare data of selective case in response to potential fraud for closed file review (CFR) process. • Summarize and prepare CFR result presentation to update Head of Claim. 2. Claim Governance: • Handle monitoring claim governance log i.e. risk management, audit issue, standard control, or regulation report from related parties. • Manage and monitor those governance logs with process owner to ensure it’s still under standard, fixed within the agreed timeline and align with Generali’s policy and regulation. • Update SOP in case process is adjusted to follow Generali’s policy and regulation. • Prepare data and presentation to update Head of Claim regarding progress of the governance.

Experience Requirement

• Bachelor’s degree or higher in any fields. Fresh graduate is welcome. • 1-3 years experienced in claim or data analytic or insurance operation is advantage. • Analytical skill, logical and initiative skill, good communication, service mind, proactive teamwork, ability to work with under pressure. • Good at English language • Excellent Computer skill : Ms Office, Pivot, Power Point and Infographic

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