health claims handler & fwa analytics expert

You will lead initiatives to detect, prevent, and mitigate Fraud, Waste, and Abuse (FWA) in health insurance claims. You’ll combine operational claims expertise with data analytics, working closely with data scientists, engineers, and compliance teams to design and implement solutions that protect our customers and reduce financial risk.

Your day-to-day:

• Review health claims and identify patterns or anomalies that may indicate fraud or abuse

• Collaborate with data teams to define business requirements for FWA detection models

• Translate operational insights into data features for predictive modeling and anomaly detection

• Validate analytical outputs and ensure alignment with claims logic and regulatory standards

• Support the development of dashboards and reporting tools for monitoring suspicious activity

• Recommend corrective actions and process improvements based on analytical findings

• Train claims teams and external partners on emerging fraud trends and prevention techniques

• Communicate complex insights in clear, actionable terms to non-technical stakeholders

Qualifications:

• 8+ years of experience in health claims management, including 3+ years in fraud detection

• Familiarity with data analytics concepts (e.g., predictive modeling, anomaly detection)

• Ability to work with SQL, Power BI/Tableau, and understand data pipelines

• Deep understanding of health insurance workflows, coding standards, and regulatory compliance

• Strong analytical thinking, communication, and stakeholder engagement skills

Preferred Skills:

• Exposure to machine learning applications in healthcare

• Experience with FWA tools (e.g., SAS Fraud Framework)

• Certification in fraud examination (CFE) or healthcare compliance

What we offer:

• Extensive training opportunities - on-demand and on-site options

• Partnership with multiple educational institutions across Greece for advanced education, with tuition support

• Comprehensive Health Insurance that keeps you safe, with peace of mind and financial protection in times of need

• Pension Scheme to secure your financial future

• Well-being and work-life balance

• One-time budget for home-office equipment to make your work-from-home comfortable

• Recognition and rewards for excellence

• Monthly meal allowance

• Recently renovated offices, central location, with easy access

Ready to join us?

If you’re passionate about protecting the integrity of health insurance operations and enjoy working at the intersection of claims and analytics, we’d love to meet you!