The African Talent Company | TATC

Fraud Analyst (French Speaking Mandatory)

Job Summary

Our client provides health insurance services around the world. They are passionate about helping people improve their health, well-being, and sense of security. They started over 200 years ago and we continued to innovate and expand ever since. They focus on the unique needs of Intergovernmental (IGO) and Non-governmental (NGO) organizations, as well as the needs of multinationals in Europe and Africa. What makes them different from other employers? They go further than just paying insurance claims. Solid customer relationships are our main goal. They also strongly believe in business ethics and continually strive to be cleaner, greener, and respectful of all. They owe their success to the talent and dedication of their team. They’re the ones who make a difference in our customers’ lives. So they know that it’s important to go the extra mile for their employees. They make sure they have a good work-life balance and they offer many initiatives for health and well-being.

  • Minimum Qualification: Bachelor
  • Experience Level: Senior level
  • Experience Length: 5 years

Job Description

YOUR RESPONSIBILITIES

  1. You review and analyze triggered cases based on pre- and post-payment risk assessments and take appropriate action.
  2. You assist in analyzing files that are passed on to the FWA team for suspected fraud, waste or abuse.
  3. You support the team of investigators in gathering facts on suspected cases with a special focus on African health care providers.
  4. You give advice for claims release and track steps taken accordingly.
  5. You assist in reaching out to suspected providers in Africa and conduct fact-finding interviews.
  6. You help reveal patterns of fraud, waste or abuse in your designated region through data-mining exercises.
  7. Based on your initial analysis, you are able to summarize your findings in a report, to be directed to the region’s senior investigator.
  8. You follow-up with stakeholders to ensure deadlines are met and any delays are communicated proactively.
  9. You manage your workload proactively, communicating with your manager any risks or challenges to targeted completion dates.
  10. You are able to identify and take an active role in optimizing workflows of the department.
  11. You take initiative and show confidence in your correspondence with internal and external parties.


YOUR PROFILE

  • Bachelor degree or equivalent through experience. Any prior experience in the field is preferred.
  • Excellent knowledge of French (Written and Spoken) Any additional languages is a plus.
  • Good medical knowledge or a strong interest in exploring the medical field is preferred.
  • Strong knowledge of Microsoft Office, especially Excel.
  • Analytical and have a critical mindset.
  • Decisive and able to work independently as well as within a team.
  • You act with the highest integrity and respect for procedures and regulations.
  • You work efficiently and accurately.
  • You are excellent in setting priorities.


INTERESTED?

If you are interested in this position, please submit your resume.

Share Job Post

Log In to apply now

Moringa School
Nairobi
| Full Time |
KSh Confidential
Job Function: Consulting & Strategy
1mo
Planned Parenthood
Nairobi
| Part Time |
KSh Confidential
Job Function: Consulting & Strategy
3w
Anonymous Employer
Nairobi
| Full Time |
KSh 60,001 - 75,000
Job Function: Consulting & Strategy
2w
Nairobi
| Full Time |
KSh Confidential
Job Function: Consulting & Strategy
5d