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We are looking for a Senior Health Claims Expert – Individual Claims to join our Life &amp; Health Claims Division. In this role, you will lead initiatives to detect, prevent, and mitigate Fraud, Waste, and Abuse (FWA) across health insurance claims, combining deep operational expertise with advanced analytics. You will collaborate closely with data scientists, engineers, and compliance teams to design and implement solutions that strengthen claims integrity and minimize financial risk.What You Will Do:Claims Expertise &amp; Oversight<ul><li>Provide subject matter expertise on health claims processes, adjudication rules, and regulatory compliance.</li><li>Review and validate claim patterns, anomalies, and high‑risk indicators identified through analytics.</li></ul>Collaboration with Data Teams<ul><li>Partner with data analysts and engineers to define business requirements for FWA detection models.</li><li>Translate operational insights into data features used in predictive modeling and anomaly detection.</li><li>Validate model outputs and ensure alignment with business logic and balanced risk‑based decisions.</li></ul>Fraud Detection &amp; Prevention<ul><li>Support the development of advanced FWA strategies leveraging analytics, AI, and rule‑based systems.</li><li>Contribute to the creation of dashboards and reporting tools for monitoring suspicious claim behaviors.</li><li>Recommend corrective actions and process improvements based on analytical findings.</li></ul>Stakeholder Management<ul><li>Communicate complex analytical insights to non‑technical stakeholders in a clear and actionable manner.</li><li>Train claims teams (including TPA partners) on emerging fraud trends and data‑driven prevention techniques.</li></ul>What You Bring:Required<ul><li>8+ years of experience in health claims management, including at least 3 years in fraud detection.</li><li>Familiarity with analytics concepts (predictive modeling, anomaly detection).</li><li>Ability to work with SQL and dashboards (Power BI/Tableau), and understand data pipelines.</li><li>Strong understanding of the health insurance market, coding standards, and claims workflows.</li><li>Excellent analytical thinking, communication, and stakeholder engagement skills.</li></ul>Preferred<ul><li>Exposure to machine learning applications in healthcare.</li><li>Experience with FWA tools (e.g., SAS Fraud Framework).</li><li>Certification in fraud examination (CFE) or healthcare compliance.</li></ul>What We Offer:• Extensive training opportunities – on-demand and on-site • Partnerships with educational institutions across Greece for advanced study, with tuition support • Comprehensive Health Insurance for peace of mind and financial protection • Well-being support and work–life balance • One‑time budget for home-office equipment • Recognition and rewards for excellence • Monthly meal allowance • Newly renovated, centrally located offices with easy access

Senior Health Claims Expert (Individual Claims)

Responsible for the Workplace Experience and Operations for a geographical region spanning 10 countries, our Workplace Managers combine People, Technology, and Space across Office and Serviced Office locations to create an exceptional workplace experience for our Employees, Visitors, Contractors and Courier Partners. Regional Workplace Managers support their direct reports (in country workplace managers) to perform at their best, providing guidance and oversight to ensure our workplaces’ functionality, comfort, safety, sustainability and efficiency;&nbsp; whilst ensuring that our office ‘hubs’ are properly set up for collaboration and focus as well as our smaller satellite locations without onsite staff appropriately situated, supported and well-equipped.What you’ll be doing<ul><li>Lead a regional team of Workplace Managers &amp; Workplace Coordinators in ensuring our workplace experience supports Wolt’s mission &amp; values and team objectives are met.</li><li>Setup and onboard new offices as Wolt expands in your region. Partner with business leads, local and global teams to ensure effective communication with landlords, internal and external stakeholders so that office projects in your region can be delivered on time and in accordance with both Wolt’s global standards and any local requirements.</li><li>Ensure all sites within the regional portfolio are managed and maintained to a high standard and in compliance with local and global policies and guidelines.</li><li>Build department policies and procedures in conjunction with Wolt’s Global Workplace and Facilities manager, complying with International Health and Safety Standards.</li><li>Partner with South region teams such as Physical Security and Safety, Sustainability and People to provide office specific program roll outs for initiatives such as Health and Safety, Sustainability and DEI, Internal Events and Community.</li><li>Partner with Integrated Facilities Management Vendors to ensure safe and compliant workspaces and that service level agreements are met. Conduct formal site condition inspections and work closely with responsible parties to ensure any deficiencies identified are resolved.&nbsp;</li><li>Create and own the development of annual Opex budgets for your region, tracking and reporting on financial variance and operations expenses management.</li></ul>Our Humble Expectations<ul><li>8+ years previous experience and regional role experience Workplace or Facilities Management in a global organization within a fast-paced and high growth environment</li><li>Bachelors or equivalent years of experience. Industry body qualifications&nbsp; (IWFM, CFM or similar) are a bonus.</li><li>Excellent organizational skills and attention to detail</li><li>Strong leadership capabilities, proven experience to motivate and lead a team</li><li>Excellent communication and interpersonal skills, and the ability to work with internal and external stakeholders</li><li>A demonstrated ability to work collaboratively across departments and levels within a complex organization.</li><li>Ability and willingness to travel in order to properly support all locations in-Region (especially during office relocations and openings)</li><li>Excellent written and verbal communication skills in English. Ability to work autonomously in a fast-moving environment, strong relationship building and stakeholder management skills, and a true growth mindset to consistently learn and develop skills.</li><li>Comfortable collaborating remotely and dynamically using digital tools such as GSuite, Slack and Zoom.</li></ul>

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senior health claims expert (individual claims)

NN Hellas

regional workplace manager, region south

Wolt Greece

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