Claims Insights, Principal

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
- As pioneering innovators for over 100 years, we’re now transforming our organisation to be faster, simpler and more connected. Because we want to be even better equipped to develop digital solutions and experiences that help more people live Healthier, Longer, Better Lives._
- To get there, we need people with _tech/digital/analytics_ expertise and passion to help develop positive, sustainable change through digitally enhanced experiences that will impact the lives of millions of people and create a healthier future for everyone._

If you believe in developing a better tomorrow, read on.

About the Role

Responsible for health analytic initiatives with timely and accurate data driven insights to enable the business translate action into sustainable business impact.
Support Healthcare’s strategy formulation, implementation and tracking; whilst keeping abreast with industry developments and channeling this critical information to Management in driving the business.

Roles & Responsibilities:
Health Analytics
- Support IHS Healthcare KPI metrics, analyzing claims data, and identify trends and insights for medical inflation, cost driver and claim saving.
- Develop strategic initiatives that optimize cost, quality, and efficiency within healthcare claims operations
- Work on ad-hoc analysis, identify discrepancies and patterns to evaluate actions for day-to-day operations, translate technical findings into easy to understand terms for the business.
- Drive consistency and best practice in data and analytics translation and ensuring high quality and timely delivery of outcomes.
- Support AIML/OCR/EDI solutions to optimize operation performance and incorporated into analytic data scope.

Strategic Planning
- Develop and implement strategies to improve claims processing efficiency, reduce fraud, and enhance payer-provider collaboration.
- Stay updated on industry trends, regulatory changes, and reimbursement policies to ensure compliance and competitive advantage.
- Monitor key performance indicators (KPIs) related to claims accuracy, turnaround times, and cost containment.
- Collaborate with Finance, Actuarial and Provider Management to align claims strategy with business goals.

BI & Reporting
- Maintenance business intelligence tools, databases, dashboards, system or methods to ensure best practices are in place.
- Adopt automation, simplification, standardization and self-serve capabilities in Power BI dashboard or report development.
- Produce management reports to ensure healthcare strategy and claims saving to facilitate business decision on a timely basis.

Data Governance & Management
- Support governance of data integrity and best practices for analytics to be used for current and succeeding projects.
- Determines data requirements, collect data from various sources and transform data into information that can be utilized for business decisions and operational strategy.

Minimum Job Requirements:

- Degree graduate (or above) in numerate discipline e.g., Actuarial Science, Economics, Data Science, Mathematics, Statistic, or Computer Science.
- A least 3-5 years of related working experience in analytic roles or relevant fields. Experience in Insurance Operations or Healthcare analytics would be a plus.
- Exposure to data analytics project lifecycle (data requirement, extraction, exploration, transformation, development, implementation, insights).
- Proficient in SQL programming or other database query tools and strong capability with dashboard tools including Power BI and Tableau.
- Strong knowledge of data models, mining, segmentation, machine learning techniques and algorithms will be an advantage.
- Excellent communication and presentation skill with the ability to articulating findings insights to stakeholders and senior management.
- Adaptive to change and flexible in an evolving, fast-paced, and high-pressure working environment.
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._