Watch Industry Experts Discuss
The Use of New Technology in Fraud Detection and Mitigation
May 04, 2021 | 1:00 PM (EST)
The ACE Leadership Forum is designed to cover the most critical issues facing claims and insurance executives from emerging risks to the evolving workforce to enriching the customer experience.
1:00 PM - 1:45 PM | The Use of New Technology in Fraud Detection and Mitigation
The discussion will focus on the adoption status of advanced analytical techniques using AI to evaluate claims for possible fraud. Additionally, we will examine if new technologies can do a better job of identifying true positives to be referred to the special investigations unit.
Points of discussion will include:
What are some of the new tools to first identify claims for possible fraud?
What tools are currently available to SIUs for investigation?
Anything new and different?
Moderator: Anand Shirur, Senior Vice President – Product Development - Klear.ai
Jessica Albano, SIU Unit Leader - Westfield
Frank Neugebauer, Senior Architect - Cincinnati Insurance Companies
Steve Robles, Assistant Chief Executive Officer - County of Los Angeles
Dennis Tierney, Senior Vice President, National Director of Workers’ Compensation Claims - Marsh
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The flagged transactions are rolled up at a Provider Level (Physician or Entity) to display a unified 3-Digit risk rating score. The intelligent score measures the risk posed by a provider in terms of Frequency, Severity and Breadth – covering the magnitude and the methodology of fraud, abuse and wastage being perpetuated by a provider.
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