Specialist, Claims & Fraud Operations

USA Job Function Description:

Responsible for the day-to-day operations of the company's business units. Aims to deliver superior service to clients by driving and optimizing the effectiveness and efficiency of people, processes and technology thereby enhancing financial performance, increasing investment capacity, and managing risk. Builds the sustainable repeatable capabilities that support delivery of the highest standards of service and execution. Analyzes and reviews data tools, business processes and operational standards to execute service delivery. Evaluates and ensures that operations meet company objectives, business needs, service agreements and relevant requirements. Researches and monitors external landscape to identify developments and translate them into operational implications for the company.

Essential Functions/Responsibility Statements:

• Analyzes current fraud trends and provide input into rules and parameters.
• Develops and maintains Policy and Procedure Manuals.
• Develops registration & licensing documents, policy and procedure manuals, and other documentation as needed.
• Completes governmental reports such as SAR.
• Investigates fraud claims involving ACH, Pre-authorized drafts, altered check, forged endorsements, unauthorized third party transfers, elder fraud, identity theft or other operations fraud issues.
• Researches discrepancies, accumulate all necessary information and take appropriate action to stop, and where possible, prevent fraud and identity theft losses.
• Reviews daily reports for unauthorized share activity.
• Maintains case files and work with law enforcement agencies and internal departments.
• Enters fraud cases in the case management system.
• Reports suspicious activity as required by the Bank Secrecy Act.
• Assists in the preparation of filing bonded claims and un-bonded charge off recommendations.
• Conducts daily new business and member account and/or changed account review and due diligence actions in compliance with the USA Patriot Act Member Identification Program (MIP).

Education:

Bachelor's Degree or equivalent work experience (Req)

Work Experience:

Experience in loss prevention, fraud, regulatory compliance, fraud prevention or security area preferably in financial services., 0+ years
,

Skills and Abilities:

• Working knowledge of loss and fraud detection/prevention principals, multiple fraud areas, compliance and regulatory issues related to the department and/or company.
• Working knowledge of fraud systems such as Lexus Nexus, Targus, Tran Union TLO
• Knowledge and experience with root cause analysis
• Solid analytical, interpretive and problem solving skills
• Ability to analyze diverse information and develop strategy recommendations
• Excellent customer service and communication skills, both verbal and written
• Excellent organization skills
• Solid ability to multi-task
• Solid knowledge of department computer applications and systems
• Proficient in MS Office Applications

Diversity & EEO …