Claims Analyst

·Analyze historical insurance data (policies, claims, endorsements, cancellations) to identify fraud patterns

·Develop, review, and optimize fraud prevention rules across the insurance lifecycle (policy issuance, mid-term changes, and claims)

·Adjust risk weights and parameters based on data-driven insights

·Identify suspicious profiles (policyholders, third parties, service providers, repair shops, etc.)

·Monitor fraud-related KPIs, such as:

·Fraud rate in claims

·Suspicion vs. confirmation ratio

·False positives

·Detection time

·Investigate anomalies in:

·Claims frequency

·Coverage usage

·Repeated entities (ID, phone number, address, vehicle, etc.)

·Perform data cross-referencing using internal and external sources

·Support the creation and maintenance of blacklists and risk profiles

·Conduct testing and validation of new fraud rules (including A/B testing)

·Research a...