Compliance Fraud Analyst I

Aflac is a Fortune 500 company and industry leader in voluntary insurance products. They are seeking a Compliance Fraud Analyst I to conduct data mining and analyses to identify potential fraudulent activities, while maintaining effective data systems and supporting compliance with regulatory requirements.

Responsibilities

• Researches, plans, organizes, and conducts data mining and analyses of enterprise wide Aflac data to identify the possibility of fraudulent or suspicious activities; scope to include employees, policyholders, accounts, associates, brokers, hierarchy, TPAs, and entities; focus to include operational objectives, special projects, or ad hoc requests as assigned
• Establishes and maintains effective data in the systems, and chronological and specialized project reference files to meet current reporting needs and future enhancements; performs research and analysis to provide accurate and meaningful information
• Guided by more experienced analysts while operating with latitude for independent action and decision-making within the framework of established policies and procedures; works under minimal supervision providing assistance on department process analysis or investigations; establishes sound internal control practices and consistent interpretation and implementation of department policy and standards across the organization; supports the awareness and understanding of and monitors adherence to all applicable regulatory requirements, policies, procedures, and department processes to ensure that the appropriate control environment is documented and tracked, being mindful of priority, expiration, and deadlines
• Executes department process and procedure reviews; provides input on recommendations, changes, or enhancements that streamline activities or enhance service turnaround times, productivity, and quality; facilitates effective and efficient use of corporate resources; enhances customer satisfaction; coordinates workflow and task assignments, being mindful of priority, expiration, and deadlines; performs scheme research to identify possible enterprise level fraud activities or transactions with a scope that includes producers, hierarchy, policyholders, and employees
• Establishes and maintains effective working relationships within the department and throughout the organization
• Performs other duties as required

Skills

• Proficient in data analysis, process and quality control, and associated tools and methods, including graphical analysis; control charts; correlation & regression analysis; hypothesis testing; design of experiments; and the like
• Ability to convey methods and analyses output to all levels of employees paired with the ability to prepare statistical studies and trend analysis using internal and external information to demonstrate relevant changes or improvement
• Knowledge and understanding of corporate ethics and integrity expectations, Compliance-related metrics and understanding of field force duties, responsibilities and metrics
• Ability to work independently and as part of a team to meet deadlines in a dynamic, fast-paced environment
• Experience with Business Intelligence tools, such as Business Objects
• Excellent oral, written, and interpersonal communication skills to interact effectively with all levels of internal and external customers
• Basic knowledge and skills in Microsoft Access, Business Intelligence Reporting Tools, Business Case Preparation, Business Cost/Benefit Analysis, Financial/Budget Analysis, Business Performance Analysis & Forecasting, and Statistical Analysis
• Intermediate knowledge and skills in Microsoft Excel, PowerPoint, and Word, and Data Trend Analysis & Interpretation
• Bachelor's Degree in Statistics, Business Management, Risk Management, Criminal Justice or a related field Minimum
• One to two years of job-related experience
• Basic knowledge and skills in Visio, SAP, Adobe Acrobat, Advanced Analysis Tools, Lean Six Sigma and Statistical Analysis Tools preferred
• Knowledge, practical experience and designation/certification in one or more of the following (desired): Certified Fraud Examiner (CFE); Fraud Claims Law Specialist (FCLS); Health Care Anti-Fraud Associate (HCAFA); Certified Insurance Fraud Investigator (CIFI); Certified Insurance Fraud Analyst (CIFA); Six Sigma and/or Lean Six Sigma

Benefits

• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care flexible spending
• Dependent care flexible spending
• Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee)
• 401(k) plans
• Annual bonuses
• An opportunity to purchase company stock
• 11 paid holidays
• Up to 20 days PTO to be used for any reason
• If eligible, state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked)
• Other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being
• Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities

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