Responsibilities:
- Collaboration with Claims Technical Teams: Work alongside with the fraud investigation team to provide data insights that support investigations.
- Assist to identify, investigate, and analyze potential fraudulent life & health claims and activities
- Data Collection and Management: Gather and maintain comprehensive datasets related to life and health claims, ensuring data integrity and accuracy for analysis
- Data Analysis: Use statistical methods and data analytics tools to analyze claims data, identifying trends, patterns, and anomalies that can inform decision-making. Conduct statistical analyses to detect patterns indicative of fraud, waste, and abuse (FWA)
- Performance Metrics Development: Establish key performance indicators (KPIs) and metrics to evaluate the efficiency and effectiveness of the claims process, using data to drive improvements
- Predictive Analytics: Implement predictive modeling techniques to anticipate potential claims issues and outcomes, aiding in risk assessment and resource allocation
- Reporting and Visualization: Create dashboards and prepare detailed reports summarizing findings from data analyses, highlighting trends, anomalies, and areas of concern
- Process improvement: Work with IT and data science teams to develop and implement data-driven solutions for claims processing, including automation and machine learning applications.
- Stakeholder Communication: Present findings and insights to management and other stakeholders, translating complex data into actionable recommendations for claims strategy and operations.
- Training and Knowledge Sharing: Provide training and resources to claims staff on data analytics tools and techniques, fostering a data-driven culture within the claims department.
- Regulatory Compliance Monitoring: Use data to monitor compliance with industry regulations and internal policies related to claims handling, identifying areas for improvement.
- Assist to handle life & health claims and appeal cases
- Participate in assigned projects
Qualifications:
- A bachelor’s degree in a relevant field such as finance, insurance, risk management, data science, statistics, or engineering. A master’s degree or professional certifications (e.g., CPCU, AIC, or other relevant qualifications) may be advantageous.
- At least 3 years’ experience in claims processing, management, or technical roles within the insurance industry, particularly in life and health claims.
- Familiarity with fraudulent and wasteful activities within claims, including experience in detection, investigation, and prevention.
- Proficiency in data analysis tools and programming languages (e.g., Excel, SQL, Python, R) and experience with data visualization software (e.g., Tableau, Power BI).
- Strong analytical and problem-solving abilities to interpret complex data sets and derive actionable insights.
- Understanding of industry regulations, compliance standards, and best practices related to claims management.
- Relevant certifications in data analytics or insurance (e.g., Certified Analytics Professional, Associate in Claims) can enhance credibility.
- Strong communication, leadership, and interpersonal skills to effectively manage teams and interact with various stakeholders.
About AXA Hong Kong and Macau
AXA Hong Kong and Macau is a member of the AXA Group, a leading global insurer with presence in 50 markets and serving 95 million customers worldwide. Our purpose is to act for human progress by protecting what matters.
As one of the most diversified insurers in Hong Kong, we offer integrated solutions across Life, Health and General Insurance. We are the largest General Insurance provider and a major Health and Employee Benefits provider. Our aim is to not only be the insurer to provide comprehensive protection to our customers, but also a holistic partner to the individuals, businesses and community we serve. At the core of our service commitment is continuous product & service innovation and customer experience enrichment, which is achieved through actively listening to our customers’ needs and leveraging and investing in technology and digital transformation.
We embrace our responsibility to be a driving force against climate change and a force for good to create shared value for our community. We are proud to be the first to address the importance of mental health through different products and services and thought leading iconic research. Our overall Sustainability Strategy, with emphasis on climate strategy and biodiversity commitment, is developed based on TCFD recommendations. We are committed to integrating environmental, social and governance factors across our business and strive to contribute to a sustainable future through 3 distinct roles - as an investor, an insurer and an exemplary company.
AXA is an equal opportunity employer. We are committed to promoting Diversity and Inclusion (D&I) by creating a work environment where all employees are treated with dignity, respect, and where individual differences are valued. We welcome and treasure diverse profiles to join our big family, and to build an inclusive culture together which allows everyone to maximise their personal potential.
Our people strategies are designed to enhance employee well-being and professional growth, ultimately empowering them to excel within the company.
Click here to learn more about our Benefits (https://www.axa.com.hk/en/benefits) , Culture (https://www.axa.com.hk/en/culture-and-values), & Career Development (https://www.axa.com.hk/en/career-development).