Fraud and Compliance Analyst
IF YOU CARE, THERE'S A PLACE FOR YOU HERE
For a career path that is both challenging and rewarding, join Sedgwick's talented team of 21,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets -- their employees, their customers and their property. At Sedgwick, caring counts. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.
PRIMARY PURPOSE: To research and analyze reported, alleged, or suspected fraud and other compliance as it relates to or impacts Sedgwick; to analyze data to detect fraud symptoms or compliance initiatives, to identify and prevent fraud and ensure regulatory compliance; to analyze fraud or compliance trends and to assist in the preparation of fraud and compliance reporting to carriers for state regulatory agencies or for other reporting requirements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Assists in the prevention, detection, investigation and resolution of fraud or other compliance matters through research and analysis.
Proactively assists with fraud & compliance initiatives.
Conducts data mining using data analysis techniques to detect aberrancies and outliers to identify the presence fraud symptoms.
Develops algorithms, queries, and reports to detect potential fraud or other compliance trends and patterns.
Gathers evidence and documentation to support fraud and compliance investigations.
Monitors industry news and fraud and compliance trends to develop actionable intelligence for research and analysis to assist in fraud and compliance risk identification and mitigation.
Maintains process to receive and process fraud and compliance related tips.
Supports fraud and compliance efforts regarding AML, FCPA, and OFAC laws and regulations.
Contributes to the root cause analysis on internal and external fraud and compliance events.
Performs ad hoc analysis for the compliance and regulatory group as required.
Assists in the development, presentation and compliance of fraud training for the enterprise.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Education & Licensing
Bachelor's degree in business from an accredited college or university preferred.
Five (5) years of experience, including one (1) year in research, fraud prevention, or detection or role or a combination of education of experience preferred.
Skills & Knowledge:
Working knowledge of comparing and analyzing data, trending and reviewing for the purpose of identifying abnormalities
Knowledge of the claims management process
Excellent PC, analytical, and interpretive skills
PC literate, including Microsoft Office products
Excellent oral and written communication, including presentation skills
Excellent organizational skills
Strong interpersonal skills
Familiarity with financial concepts
Ability to prioritize and manage multiple projects
Ability to work in a team environment, and independently
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer
Sedgwick Claims Management Services, Inc.