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CNA Insurance · 11 hours ago

Senior Fraud Analyst – Long-Term Care Insurance

Chicago, IL

Full-time

Hybrid

Mid, Senior Level

$54K/yr - $103K/yr

3+ years exp

CNA Insurance is seeking a highly skilled and experienced Senior Fraud Analyst to lead complex investigations into fraud, waste, and abuse within their Long Term Care insurance operations. The role involves safeguarding the integrity of claims processes by detecting fraud patterns, mentoring junior analysts, and contributing to fraud prevention strategies across the organization.

FinanceFinancial ServicesInformation ServicesInformation TechnologyInsuranceProperty ManagementReal EstateRisk Management

Responsibilities

Performs a combination of duties in accordance with departmental guidelines: Partners with Operations, Claims, and Finance leadership, as well as internal SIU, Legal and Compliance to support strategic initiatives

Analyzes operations and other data using problem solving and decision making to prepare and present reports to management; including recommendations on policies and procedures, and operational improvements or corrective action plans

Utilizes work management tools to efficiently manage caseloads and ensure performance and quality measures are achieved

Represents the functional area in meetings with management and other business units as required

Oversees project-related expenses, ensuring alignment with budget goals and financial targets

Supports management as an agent of change, building collaboration and commitment using innovative ideas and business acumen

Works with other departments and may provide technical guidance to others within the department

Supports LTC anti-fraud initiatives through data analytics by partnering with business leaders in identifying opportunities to build and analyze metrics through data visualizations, leveraging tools such as Google Cloud Platform, Looker, Power BI and other advanced data tools

Shares knowledge and collaborates across functional or geographic areas to share and incorporate learnings to improve business results and to ensure consistency, process, and outcomes

Continuously learns more and stays up to date in functional area of expertise and industry activity and trends. May participate in industry trade groups

Collaborates with management, technical staff and subject matter advisors to understand business needs/issues, troubleshoot problems, conduct root cause analysis and develop cost effective resolutions to improve operational efficiency

May be responsible for special projects and presentations

May perform additional duties as assigned

Qualification

Fraud analysisData analyticsExcelProject managementMicrosoft Office SuiteBusiness intelligence toolsCommunication skillsNegotiation skills

Required

Knowledge of industry practices, company operations and departmental functions

Excellent organizational and project management skills, with the ability to prioritize and coordinate multiple initiatives

Proficient in drafting demand letters, and interpreting policy language

Skilled in handling challenging conversations and negotiating favorable outcomes

Strong interpersonal, analytical, problem solving, verbal and written communication skills with the ability to present insights effectively across all levels of the organization

Proven ability to work independently and collaboratively, fostering solid relationships with internal and external partners

Ability to exercise professional judgement and assume responsibility for decisions which have an impact on people, costs and quality of service

Advanced proficiency in Excel and solid working knowledge of Microsoft Office Suite; familiarity with tools like Tableau, Looker, BigQuery, and other business intelligence platforms is a plus

Ability to translate complex data into compelling narratives and actionable insights through effective reporting and presentations

Bachelor's Degree or equivalent work experience and completion of applicable professional designations

Typically three to five years relevant professional experience

Preferred

Knowledge of Fraud in insurance operations preferred, especially long-term care

Benefits

CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.