Fraud Analyst

Overview: 

The Fraud Analyst will report to the Manager of the Fraud Team, under the Payee Identification and Network Security (PINS) department. The PINS department encompasses Zelis Payments’ Fraud, Risk, and Identity Verification organization and centrally manages Fraud, Onboarding/Verifications, and Account Servicing for Zelis clients, addressing issues related to account takeover, business identification, bank account validation, and more. 
 

The Fraud Analyst conducts all aspects of investigations into suspicious activity, including collecting relevant data in support of case findings, drawing sound conclusions based on assessments and the development of facts, and summarizing findings into an actionable and digestible format. They will leverage both internal and external tools and reporting, as well as their fraud-related experience, to make sound judgements to determine the level of risk and the appropriate actions to take to protect Zelis and its clients. The Fraud Specialist takes proactive measures to prevent losses, analyzes suspicious activity, coordinates responses across all stakeholders, and properly escalates significant cases of risk exposure. This role operates in a dynamic and fast-paced environment which requires effectively leveraging relationships across key business units in the organization, communicating directly with clients, and accepting constant change as a reality of fighting fraud.

In addition, a successful candidate will be passionate about fighting fraud, identifying new trends, and is naturally curious.

Role Objectives: 

• Safeguards Zelis and its clients from fraud losses and risk exposure through monitoring and Fraud Investigations. 

• Takes action based on sound judgement and exacting investigative practices to remediate any adverse impacts to minimize financial and reputational risks.

• Collaborates with PINS leadership to share best practices, identified trends, and recommendations based on insights. 

Key Responsibilities: 

• Monitors and investigates suspicious activity to identify and control fraudulent activity, such as account takeover, theft, and similar risks.

• Accurately and efficiently completes case investigations which may involve: 

• Deep dive analysis of data from various sources such as detection tools, reports, and/or internal and external referrals to evaluate, investigate, and determine required actions. 

• Leverage internal and external data sources to validate suspicious activity. 

• Facilitate client communication regarding suspicious activity to include collection of details, providing updates when appropriate, and closing the loop. 

• Ensure confidentiality of all information collected during investigations. 

• Confidently communicates via outbound communication to clients through both email and phone contact. 

• Collaborates with internal and external partners to complete and document investigation processes, identify process improvements, and help safeguard Zelis and its clients from further risk. 

• Assists the Fraud team in identifying gaps in current systems, policies and strategies, and recommends enhancements and process improvements to mitigate emerging risks. 

• Supports PINS team and other key stakeholder groups, including Enterprise Fraud, Infosec, Compliance, Payment Operations, and Treasury. 

Qualifications: 

• Bachelor's degree required  

• 3+ working experience as a Fraud Analyst or Fraud Investigator 

• Industry experience in financial institution, fintech, or payments company required; Healthcare payments industry, preferred 

• Knowledge of fraud schemes, fraud prevention methods, and fraud detection tools 

• Creative, natural problem solver, with a team-focused mentality 

• Strong attention to detail and can question the status quo to further enhance fraud mitigation strategies 

• Foundational knowledge of SQL (Snowflake, Microsoft SSMS), a plus 

• Certified Fraud Examiner, a plus 

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.