Sr Fraud Analyst

Sr. Internal Fraud Analyst

We are looking to add an integral member to our Fraud Management team. The Sr. Internal Fraud Analyst is responsible for applying data mining and analysis techniques to identify fraud trends across all carriers and employee groups. This individual will utilize findings to recommend processes and/ or procedures to mitigate losses, as well as to engage law enforcement, where appropriate, to prosecute and realize asset recovery. The Sr. Internal Fraud Analyst will have demonstrated in past roles strong data analysis skills, confidentiality, the ability to work effectively with limited supervision on tasks and projects, drive results, and build positive relationships with coworkers and customers (both internal and external).

The ideal candidate will have a high level of collaboration with other Fraud Analysts within Fraud Management and extensive involvement with multiple Product, Human Resources, Finance and Legal groups. The candidate should also be able to analyze large volumes of data from disparate data sources and identity outliers, discreet patterns, red flag behaviors and potential fraudulent activities. The Sr. Internal Fraud Analyst will have a strong interest in investigations and complex problem solving along with the ability to consider alternative perspectives, is able to think quickly and perform in high-stress situations and operate well in a strong team environment.


Analyze data sets and behavior patterns as well as utilize fraud detection tools to source new case leads
• Utilize findings of internal fraud cases to develop new reports and suggest improvements to existing reports
• Periodically meet with Customer Solutions leadership and constituents to identify internal fraud vulnerabilities.
• Identify and investigate complex and sensitive fraud cases that may contain material business exposures
• Detect fraudulent behavior and policy violations through the monthly review of expense report data and tracking software for corporate travel
• Assist in the implementation of new fraud detection tools including testing, deployment and determining optimal usage. Identify how tools and resources can be utilized by other departments and facilitate flow of information.
• Ensure that cases are researched, documented and completed in accordance with departmental, regulatory and compliance reporting standards
• Maintain confidentiality of all investigation materials and case documents
• Evaluate investigative findings and draft clear and concise investigative reports
• Present case reports to small group of stakeholders and recommend resolution
• Liaise with IT, Legal, Finance, Care and HR departments and Clients regarding investigations, acting as a subject matter expert for internal fraud
• Interact with law enforcement when warranted
• Testify in court when required
• Understand and quantify risks associated with new or proposed processes or procedural changes and representing the Fraud team in project groups and planning meetings
• Determine fraud policies and adherence and communicate to appropriate segments of the organization when there are deviations from policies
• Champion projects related to internal fraud detection and prevention
• Notify senior leadership when trends emerge and champion a solution based process to mitigate fraud going forward.
• Provide fraud awareness training
• Update job knowledge by tracking and understanding emerging fraud related practices and standards; participating in educational opportunities; reading professional publications; maintaining professional networks; participating in professional organizations
• Interest and willingness to mentor junior team members
• Perform other related duties as assigned
• The primary work location for this role is the Nashville Ragland facility. On occasion, travel to other locations may be required.


• Bachelor's Degree
• 3 to 4 years of fraud investigation or quantitative analysis experience with financial services, IT, Human Resources, auditing, property/casualty insurance, or corporate risk management
• Effectively communicate with all levels of the organization including proven ability to develop strong relationships with peer groups across multiple departments
• Excellent communication (oral, written, presentation), interpersonal and consultative skills are required
• Proficiency in SQL/Oracle, Microsoft Excel, Word, and PowerPoint, Microsoft Access preferred
• Excellent reasoning, data mining and analytical skills
• Strong problem solving and process improvement skills
• Work independently with little guidance while still meeting objectives
• Detail oriented with effective multi-tasking abilities
• CFE (Certified Fraud Examiner) certification preferred
• Travel & Expense auditing experience preferred

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