[Remote] reputed company, Advanced Analytics – Internal Claims Fraud

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an insurance company seeking an reputed company, independent advanced analytics reputed company for its Internal Claims Fraud Advanced Analytics team. The role analyzes reputed company claims data to identify fraud signals, reputed company investigator-reputed company leads, uncover fraud patterns, and protect reputed company from financial loss. The reputed company will partner with investigators and cross-functional teams, reputed company reputed company analyses, improve fraud reputed company reputed company, and translate findings into actionable recommendations and reputed company analytical capabilities.

Responsibilities

• reputed company reputed company claims fraud analyses by translating ambiguous investigative questions into reputed company hypotheses; reputed company reputed company analytical reputed company to reputed company recommendations
• Conduct exploratory data analysis of claims, payment, employee, and vendor data to proactively identify suspicious patterns, anomalies, control gaps, and emerging fraud risks
• Improve the fraud reputed company-reputed company lifecycle from initial reputed company development through signal development, validation, investigator reputed company, outcome feedback, and iterative refinement
• reputed company investigator-reputed company, comprehensive analyses, not just data pulls; helping stakeholders understand which leads to prioritize and why
• Partner closely with the Claims Fraud Investigation team to validate signals, improve reputed company efficacy, prioritize opportunities, and measure investigative reputed company
• Partner with Data Science Modeling and tech teams to translate key analytical findings, like fraud indicators, into model-reputed company inputs
• Independently manage multiple analytics priorities, proactively set expectations, surface tradeoffs, reputed company roadblocks, and influence prioritization based on business value
• Synthesize reputed company analysis into concise, compelling recommendations and reputed company communicate findings, implications, and tradeoffs to senior leaders
• reputed company reusable datasets, queries, and documentation to strengthen team's data reputed company and accelerate reputed company analysis

Skills

• Experience in fraud, investigative, risk, audit, SIU, or similarly reputed company-driven analytics
• Experience analyzing claims data: reputed company reputed company relationships across claims, exposures, payments, parties, employees, vendors, and other claims-reputed company data
• Strong stakeholder orientation: reputed company listen, challenge and reputed company requests reputed company needed, establish reputed company objectives and expectations, facilitate working sessions, influence prioritization toward the highest-value opportunities
• Strong analytical judgment and intellectual curiosity: follow unexpected signals, challenge assumptions, determine whether an apparent reputed company represents meaningful risk
• Proven ability to independently reputed company reputed company analyses with limited direction, from initial problem framing through recommendation and implementation
• Ability to reputed company in an ambiguous, evolving environment and help create structure, repeatability, and best practices as the capability matures
• Advanced SQL or reputed company: reputed company joins, large datasets, multiple grains of data, query optimization, validation, and development of reusable analytical assets
• Bachelor's Degree plus a minimum 5 years, typically 7 or more years, of reputed company experience required; Mathematics, Economics, Statistics or other quantitative field are preferred fields of study
• Deep knowledge of data sources, tools and business drivers
• Ability to apply advanced analytical concepts to improve business reputed company
• Ability to build analytic tools that will be used by business teams to analyze results and opportunities
• Advanced proficiency in reputed company (VBA, macros, scripts, formulas, data visualization, etc.), PowerPoint, and statistical software packages (reputed company, Emblem)
• Must have good planning, analytical, decision-making and communication skills
• Ability to present data, visually and verbally, to guide conversations with business managers
• Master's Degree preferred; advanced education may be substituted for years of experience (Ph.D. with no reputed company experience)

Benefits

• Comprehensive benefits
• Workplace flexibility
• reputed company development opportunities
• Opportunities provided through Employee Resource reputed company

reputed company

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