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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging ... users for more effective screening and follow-up care. Predictive modeling;Health risks;Data mining=Big ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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Addressing climate change belongs in the insurance companies
mitigation sides. The study has revealed that eight primary factors hinder the expansion of market- based ... of 21 primary insurance and reinsurance companies around the world. These included twelve primary insurers ...- Authors: Maryam Golnaraghi
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance; Leadership>Change management; Leadership>Influence; Leadership>Professional network leverage; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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NAIC Valuation of Life Insurance Policies Model Regulation - XXX
Lincoln quote along the way. I’ll be covering three primary areas of interest related to the valuation actuary ... been in the market for many years, and it was the primary focus of XXX in its two incarnations. Segmented ...- Authors: William C Koenig, Timothy Pfeifer, Wayne Stuenkel, Lloyd Spencer, Mary J Bahna-Nolan
- Date: Sep 2000
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Topics: Actuarial Profession>Standards of practice; Financial Reporting & Accounting>Statutory accounting; Life Insurance>Reserves - Life Insurance; Public Policy
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How to Turn Suspects Into Prospects
How to Turn Suspects Into Prospects By Ray Mascola Communication;Operational Management;Time ... priorities. By actively listening you show that you care and in the process you develop credibility and trust ...- Date: May 2017
- Competency: Communication>Active listening; Communication>Difficult message delivery; Communication>Oral communication; Communication>Persuasive communication; Communication>Written communication; External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>General business skills; External Forces & Industry Knowledge>Internal forces and business performance; Leadership>Change management; Leadership>Influence; Leadership>Mentoring; Leadership>Professional network leverage; Leadership>Thought leadership; Professional Values>Ethical standards; Professional Values>Practice expertise; Professional Values>Public interest representation; Relationship Management>Relationships and trust; Relationship Management>Staff management and motivation; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Strategic Insight and Integration>Management partnership; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Innovators & Entrepreneurs
- Topics: Actuarial Profession>Entrepreneurism; Actuarial Profession>Management skills; Actuarial Profession>Professional development
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Ask The Experts
credits, which are greater than the respective direct reserve, be handled? Should they simply be calculated ... calculated and posted? Should they be capped at the direct reserve? If they’re capped, should it be in the ...- Authors: Frank M Amrine, Andrew Bodine, Armand de Palo, Mark Freedman, Charles D Friedstat, James P Greaton, Meredith Ratajczak, William J Schreiner, Stephen N Steinig
- Date: Nov 2001
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Topics: Actuarial Profession>Standards of practice; Financial Reporting & Accounting>Generally Accepted Accounting Principles [GAAP]; Financial Reporting & Accounting>Statutory accounting; Financial Reporting & Accounting>Tax accounting; Public Policy
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Reserve Criteria under Section 818c
tC and tO, especially the latter, that are of primary practical significance. These will be illustrated ... generally higher. In most of the cases where a direct comparison would indicate otherwise, a recalculation ...- Authors: Robert C Tookey, Harwood Rosser
- Date: Jun 1962
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Transactions of the SOA
- Topics: Financial Reporting & Accounting>Tax accounting; Life Insurance>Reserves - Life Insurance; Public Policy
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GAAP in Practice
and lapse assumptions that are inherent in the direct business benefit reserve. Coinsurance If the ... benefit and expenses) on the ceded business from the direct reserves. Where the ceding company receives a first-year ...- Authors: Clayton A Cardinal, Melvin L Gold, Frederick S Townsend, Paul L Weichert
- Date: Oct 1973
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Transactions of the SOA
- Topics: Financial Reporting & Accounting>Generally Accepted Accounting Principles [GAAP]
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Considerations for Indexed Universal Life under PBR
Considerations for Indexed Universal Life under PBR The article highlights key considerations ... costs, and policyholder behavior modeling are primary considerations for companies when evaluating the ...- Authors: Ye Yang, Erzhe Zhang, Nicholas Dunn
- Date: Dec 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: The Financial Reporter
- Topics: Financial Reporting & Accounting>Statutory accounting; Life Insurance>Pricing - Life Insurance; Life Insurance>Reserves - Life Insurance; Life Insurance>Secondary guarantees; Life Insurance>Product development - Life Insurance; Life Insurance>Universal life
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Global Variable Annuity Relected in New Zealand Product Design
Global Variable Annuity Relected in New Zealand Product Design New Zealand is about to launch ... the state scheme has been perceived to be the primary provid- er of retirement income. Raising awareness ...- Authors: Murray Alan Hilder, Ralph Stewart
- Date: Jan 2016
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: International News
- Topics: Annuities>Capital - Annuities; Annuities>Guaranteed living benefits; Annuities>Individual annuities; Annuities>Investment strategy - Annuities; Annuities>Marketing and distribution - Annuities; Annuities>Policyholder behavior - Annuities; Annuities>Pricing - Annuities; Annuities>Reserves - Annuities; Annuities>Product development - Annuities; Annuities>Variable annuities; Finance & Investments>Asset allocation; Finance & Investments>Asset liability management; Finance & Investments>Derivatives; Finance & Investments>Investment policy; Finance & Investments>Investments