Senior Fraud Analyst
2 months ago
About the Company
At ManipalCigna we resonate your commitment to your family’s health and well-being through a range of comprehensive Health Insurance plans. ManipalCigna Health Insurance Company Limited (formerly known as CignaTTK Health Insurance Company Limited) is a joint venture between the Manipal Group, a leader in the field of healthcare delivery and higher education in India and Cigna Corporation, a global health services company with presence in 30+ countries and serving 180 million+ customers around the world. With a deep focus on health and wellness, ManipalCigna Health Insurance offers a full suite of insurance solutions ranging from health, personal accident, major illness, travel and global care to individual customers, employer-employee, and non-employer-employee groups to meet their diverse health needs.
Job Description :
Responsible for investigating fraud cases, preparing detailed reports, and ensuring compliance with anti-fraud policies. Duties include filing FIRs and coordinating with vendors and law enforcement. Maintain accurate case documentation and provide regular updates to management
Roles and Responsibilities :
- Support in investigating fraud cases, including gathering evidence in coordination with respective department SPOC and analyzing evidence
- Manage and respond to fraud cases reported through whistleblowers and ethics emails
- Co-ordination with vendor for field reports by adhering to TAT’s
- Assist in drafting and filing FIRs in the police station as required
- Prepare investigation report
- Preparing quarterly updates of Management reports. Publish dashboards periodically
- Monitoring of implementation of mitigation/action plans for the fraud areas / Risk alerts identified
- Awareness to Employees, Agents & Intermediaries on Anti-Fraud policies
- Liaise with law enforcement agencies and other relevant authorities
- Maintain accurate and organized case files and documentation
Qualification and Experience :
1. Graduate / post-graduate with a minimum 0 – 1 years of work experience
2. Ability to work in a team
3. Able to exhibit a high level of integrity, and maturity and set ethical standards across the organization.
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