Claim Management Associate (Thai Speaker)

**Job Descriptions**:As a claim management associate, you will be responsible for reviewing claim files and all referrals that are deemed potentially suspicious. This role provides key support services to the wider investigative team and Special Investigation Unit (SIU) management.**Duties and Responsibilities**:- To collect basic information related to all manual and automatic referrals routed through locations within their area of responsibility.- Conduct a thorough analysis of all incoming fraud referrals. This analysis will include a review of Activity Notes, any previous investigative work product, and any information available through standard database searches.- To make the decision if the referrals should be forwarded to an investigator for investigation or, if they should be rejected and returned to the adjuster with an explanation regarding the reason for rejection.- Conduct a segmentation of accepted cases to determine the appropriate process for each investigation. In addition, the cases must be evaluated for their complexity.- Assist in managing assignment workflow and caseload balancing with the investigative staff. This is to ensure efficiency in investigations.- Provide coaching/feedback to adjusters and claims management on the quality of referrals. This process is key as part of their role in providing training to those personnel who are making manual referrals. This process will increase quality of referrals which will drive up the acceptance rate of new fraud referrals for the analyst.- Track metrics and trends that are to be shared with the organization and report accordingly to Special Investigation Unit (SIU) management.- In addition to the manual referrals, analyst will be required to provide specific input used to make adjustments to fraud detection models to improve the quality of automated referrals.- Act as a single point of contact for fraud-related intelligence, including handling, processing and evaluation.- The analyst will also collaborate closely with the Senior Triage Analyst to ensure smooth running to the triage process and assist Special Investigation Unit (SIU) management with ad hoc projects or tasks.**Job Requirements**:- Basic understanding of trends and behaviors in insurance fraud.- Strong written and verbal communication skills.- Proficient in the Thai language (reading, writing and speaking)