Posted By
Posted in
Banking & Finance
Job Code
1404864
Responsibilities:
- Oversight of Fraud Risk & Abuse control concerning claims.
- Engaging in fraud prevention and detection, remaining informed about the latest developments and procedures in fraud risk management.
- Establishing a Code & Ethics framework to manage consequences effectively.
- Gathering intelligent data (both internal and external), integrating data from various sources and formats.
- Utilizing text analytics to derive additional insights from unstructured data like claim notes and investigation reports.
- Employing advanced claims analytics to subject all suspicious claims to machine learning models.
- Conducting investigations into instances of fraud & misconduct in accordance with organizational guidelines and ensuring appropriate and timely action.
- Developing, reviewing, and implementing Anti-Fraud Policy, Fraud management plan, and Fraud Risk Assurance Frameworks.
- Drafting SOPs on fraud mitigation processes and enhancing them by updating fraud identification triggers regularly.
- Compiling various regulatory and governance reports including FMR, conduct risk metrics, and fraud packets.
- Ensuring comprehensive updates to the Audit Committee regarding existing and potential frauds, as well as control deficiencies.
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Posted By
Posted in
Banking & Finance
Job Code
1404864
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