Zelis Healthcare - Gainesville, FL

posted 5 months ago

Full-time
Remote - Gainesville, FL
Professional, Scientific, and Technical Services

About the position

The Fraud Reporting & Insights Analyst is a crucial member of the Zelis Payments Payee Identification and Network Security (PINS) team, reporting directly to the Senior Director of PINS. This role collaborates with the Fraud team to provide analytical and data-driven insights that shape the Fraud program. The primary responsibilities include supporting fraud detection and prevention efforts, developing rules, generating reports, and minimizing losses due to fraud by analyzing both third-party and first-party data. This role serves as part of investigations, review, and resolution of suspicious activity. Leveraging your expertise in fraud analytics, you will develop and scale metrics for the fraud team, continuously evolving and automating fraud analytics to keep pace with the changing fraud landscape and growing business needs.

Responsibilities

  • Analyze fraud history and current reporting capabilities to enhance and develop new fraud prevention controls
  • Use SQL, Snowflake, and other tools to generate daily fraud reports and provide suspicious activity data to investigators
  • Collaborate with Zelis' enterprise data science team to create sophisticated fraud modeling and reporting algorithms for proactive detection and analysis
  • Lead the development and implementation of advanced analytics, gathering and reporting data from various internal and external sources
  • Automate insights with visualization tools like PowerBI, including KPI metrics, performance dashboards, and other business insights
  • Report trends and summarize outcomes to executive stakeholders
  • Assist the Risk and Controls department with compliance and risk-related tasks

Requirements

  • Bachelor's degree in business and/or Computer Science
  • 5+ years working experience within Fraud/Risk/Compliance
  • Microsoft SQL Studio, Snowflake, and Python experience
  • Fraud Analytics experience

Nice-to-haves

  • Experience with PowerBI, Tableau, or other data visualization tools
  • Experience using Jupyter
  • Jira and Confluence
  • Healthcare Payments Industry experience
  • Certified Fraud Examiner
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