Job Description
Primarily responsible for management of risk that Apollo Munich is exposed to, through fraud & abuse by individuals & institutions.
Review reports of suspected fraud to determine need for further investigation.
Train others in fraud detection and prevention techniques. Maintain knowledge of current events and trends in such areas as mechanisms of fraud and techniques of system abuse. Evaluate business operations to identify risk areas for fraud. Recommend actions in fraud cases.
Research or evaluate new technologies for use in fraud detection systems.
Negotiate with responsible parties to arrange for recovery of losses due to fraud.
Ensuring requisite manpower To transfer knowledge and help team members develop to be future ready, thereby creating pool of talented individuals within the team
Responsibilities include helping team achieve specified objectives
To carry out continuous improvement initiatives in the processes Drive all initiatives planned and keep management updated on regular basis Analytics:
Building fraud detection models in partnership with actuarial team Investigations:
Empanel Investigators, assign cases, ensure SLAs are maintained and quality adherence
Engage with Industry councils (GI), providers, physicians, distributors, et al Enhancement & Development of IT systems Innovate:
Use of behavioral models, social media, etc. for fraud detection
Desired Candidate Profile
Please refer to the job description above
Key Skills
Key Skills
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Investigation, Fraud Detection, Risk Management, Fraud & Abuse etc
Qualification
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Any Post Graduate
Additional Qualification
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Investigation, Fraud Detection, Risk Management, Fraud & Abuse etc
Industry
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Banking/Financial/Insurance Services
Functional Area
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Others
Job Role
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Other