Zelis Healthcare
posted 5 months ago
The Fraud Reporting & Insights Analyst is a vital member of the Zelis Payments Payee Identification and Network Security (PINS) team, directly reporting to the Senior Director of PINS. This role is integral in collaborating with the Fraud team to provide analytical and data-driven insights that shape the Fraud program. The primary responsibilities encompass 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. In this position, you will be involved in investigations, reviews, and resolutions of suspicious activities. Utilizing 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 the growing business needs. This role requires a proactive approach to enhance fraud prevention controls and to ensure that the organization remains ahead of potential fraud threats. You will analyze historical fraud data and current reporting capabilities to enhance and develop new fraud prevention controls. Your work will involve using SQL, Snowflake, and other analytical tools to generate daily fraud reports and provide suspicious activity data to investigators. Collaboration with Zelis' enterprise data science team will be essential to create sophisticated fraud modeling and reporting algorithms for proactive detection and analysis. Additionally, you will lead the development and implementation of advanced analytics, gathering and reporting data from various internal and external sources, and automate insights with visualization tools like PowerBI, including KPI metrics, performance dashboards, and other business insights. Reporting trends and summarizing outcomes to executive stakeholders will also be a key part of your responsibilities, along with assisting the Risk and Controls department with compliance and risk-related tasks.