Fraud Prevention Associate researches and analyzes potential customer fraud cases to identify and prevent future fraud. Reviews and responds to suspected fraudulent service requests and identifies fraudulent transactions using various research methods. Being a Fraud Prevention Associate follows standard procedures to document a loss and prepares a summary and reconciliation. Communicates the status and resolution of the incident to the customer and/or bank. Additionally, Fraud Prevention Associate identifies areas that need increased security procedures or software to protect customer accounts. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Fraud Prevention Associate works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Fraud Prevention Associate typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
-Daily review of Electronic Visit Verification (EW) entries in LaSRS to ensure the entries are consistent with acceptable home or community locations. This includes review of GPS coordinates to verify locations.
-Identification of suspect entries
-Review of supporting documentation for suspect entries
-Communication with workers to obtain explanations for suspect entries and reminders of EW requirements
-Documentation of conversations with workers regarding suspect entries
-Preparing investigation reports
-Weekly analytical and performance reports
-Electronic scanning of documents as needed
-Deal effectively with consumers, employees and the general public as needed
-Perform other similar or related duties as assigned
-Cooperation with other law enforcement or other governing entities pursuant to substantiated cases.
Requirements:
-High School Diploma
-PC proficiency
-Advanced skills in MS Word, Excel, and a working knowledge of MS Access.
-Typing minimum of 50 wpm.
-Maintaining confidentiality and discretion in the course of conducting business Ability to multi-task
- A minimum of 3 years' experience in a similar environment (high education may be substituted for this requirement)
-Demonstrate tact, above average communication skills, ability to work effectively with co-workers and managers.
The Fraud Control Clerk is a member of the Administrative Department of AHS. The Fraud Control Clerk will monitor Medicaid and other insurance claims to identify and investigate suspected fraud. Position will lead, participate in, or assist with collection and storage of evidence (to include electronic data and evidence) for substantiated and unsubstantiated fraud.
Job Type: Full-time
Pay: From $15.00 per hour
Expected hours: 36 – 40 per week
Benefits:
Schedule:
Experience:
Work Location: In person