Fraud Business Analyst

1 month ago

Raleigh, United States Diverse Lynx Full time

JOB DESCRIPTION-

Job Title-

Fraud Business Analyst

Location-

ONSITE-

Raleigh, NC / Phoenix AZ

Duration-Long Term

Relevant Experience(in yrs)-- 7-10

Roles & Responsibilities

-

Maintain or exceed established standards for customer service, and resolves complex issues with little or no supervision or direction;

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Analyze data from multiple sources to identify discrepancies and what, if any, remedies can eliminate suspicion and maintain compliance;

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Work with peers and Managed Services leadership to communicate fraud trends and share best practices, ideas and information;

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Assist in maintaining basic ecommerce duties including chargeback handling and review;

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Review queued transactions and independently determine if the reviewed transactions are fraudulent or legitimate;

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Monitor our automated fraud screening application;

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Communicate effectively with the team by;

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Investigate anomalies in underwriting that could potentially include fraud;

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Write reports and document evidence, findings, and recommendations;

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Perform manual fraud review in order to detect fraudulent transactions;

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Independently resolve problems that require in depth investigation and/or research;

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Conduct follow-up research on fraudulent transactions;

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Conduct extensive research to validate purchases;

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Educate staff and contractors on fraud and associated behaviors.

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Previous Banking fraud prevention, investigation or fraud prevention experience is a plus;

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Demonstrated experience and/or strong working knowledge of Microsoft Word, Excel, and Outlook;

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Strong desire to build a career in the fraud industry;

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Excellent organizational, analytical, and critical thinking skills;

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Ability to meet deadlines and prioritize deliverables;

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Strong customer service skills and a demonstrated ability to take initiative, conduct thorough research, and be professionally persistent;

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Strong innovative problem-solving capabilities;

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Must have understanding of technical and financial aspects of the health insurance industry;

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Strong oral and written communication skills;

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Must possess excellent communication skills and be detailed oriented;

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Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency;

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Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required;

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Self-starter with the ability to work under pressure independently and as part of a team;

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Ability to think strategically and act proactively to create strong trust and confidence with business units.

Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.

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