Fraud Detection Analyst

The Fraud Detection Analyst is responsible for monitoring and analyzing detailed reports to identify potential fraud trends and patterns to minimize potential losses. They will conduct thorough investigations of suspicious activity related to fraud, which may include, recommending appropriate course of action, resolving client and participant questions, evaluating trends to enhance fraud mitigation, and preparing reports for fraud analysis upon request.

Key Responsibilities

•  Applying analytical skills to review large reports of data thoroughly to identify concerning behavior and/or non-obvious correlations.
• Conducts detailed investigations into suspicious fraudulent activity ensuring lessons learned are incorporated back into the process if necessary. Verify banking account information on multiple participant accounts.
• Monitors participant social security numbers to ensure accuracy and reports discrepancies to a Client Support Specialist.
• Place appropriate holds on accounts identified as having potential fraudulent issues, document action taken and track status through resolution.
• Review and submit debit card dispute forms and follow-up with the vendor as needed.
• Monitors debit card activity, including refunds, and communicates with participants to take appropriate action on their account.
• Proactively identify and communicate fraud patterns and emerging trends to management.
• Communicates with members by phone or email to verify transactions and resolve fraud-related account issues.
• Assist with the fraud hotline as needed; may be responsible for taking escalation or overflow calls.
• May assist with delivering and developing training for the Reimbursement Account Services team on fraud prevention and detection.
• Assist with adjudication requests to identify force posts and monitor for patterns.
• Performs quality assurance reviews.