Senior Fraud Investigator

3 weeks ago


Mumbai, Maharashtra, India ManipalCigna Health Insurance Company Ltd. Full time
About ManipalCigna Health Insurance Company Ltd.

We are a joint venture between the Manipal Group and Cigna Corporation, offering a range of comprehensive health insurance plans. Our focus is on health and wellness, providing insurance solutions for individuals, employer-employee, and non-employer-employee groups.

Job Description:

As a Senior Fraud Analyst, you will be responsible for investigating fraud cases, preparing detailed reports, and ensuring compliance with anti-fraud policies. Your duties will include filing FIRs, coordinating with vendors and law enforcement, and maintaining accurate case documentation.

Key Responsibilities:
  1. Investigate fraud cases, gathering evidence and analyzing data in coordination with respective department SPOCs.
  2. Manage and respond to fraud cases reported through whistleblowers and ethics emails.
  3. Coordinate with vendors for field reports, adhering to TATs.
  4. Assist in drafting and filing FIRs in the police station as required.
  5. Prepare investigation reports and quarterly updates for management.
  6. Monitor the implementation of mitigation/action plans for fraud areas and risk alerts.
  7. Awareness and training for employees, agents, and intermediaries on anti-fraud policies.
  8. Liaise with law enforcement agencies and other relevant authorities.
  9. Maintain accurate and organized case files and documentation.
Requirements:

We are looking for a graduate or post-graduate with a minimum of 0-1 year of work experience. You should be able to work in a team, exhibit high integrity, and set ethical standards across the organization.



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