Bilingual E-Commerce Control Auditor

About the role

Manulife’s Customer Experience Investigation Services department, an industry leader in fraud prevention, is looking for a dynamic individual to join its team. This department is dedicated to preventing, detecting and investigating incidences of fraud and abuse against its benefit plans. The E-Commerce Control Auditor, Investigation Services is responsible for applying Group Benefits knowledge, attention to detail, problem solving abilities, customer service, investigation and data analysis skills to identify, investigate and prevent fraud and abuse. Additionally, this role will support the Ma…

Requirements

• Bilingual (French & English) is required - The successful candidate will be required to communicate in English and French in order to support clients from various jurisdictions outside of Quebec.
• University degree or equivalent work experience
• Knowledge of Group Benefits
• Knowledge of the Canadian healthcare environment, service delivery model and regulation
• Knowledge of fraud and abuse risk, and techniques to manage risk
• Ability to manage contentious interactions with various stakeholders
• Excellent oral communication (both phone and face to face) and written communication skills
• Intermediate data analysis skills with expertise using Excel and other data mining software
• Ability to be creative, critical and aggressive in managing audit and investigative activities
• Organizational skills and the ability to manage multiple conflicting priorities
• When You Join Our Team
• We’ll empower you to learn and grow the career you want.

What you'll do

• Perform risk-based data profiling and analysis to identify trends and outliers in various categories for further review and investigation
• Lead and support audit programs; coordinating, assessing, and making decisions on investigations
• Take initiative and lead investigations to successful conclusions including the preparation of criminal and regulatory complaints
• Conduct interviews with plan members, providers of service and others
• Create written audits and other correspondence to plan members, providers of service and others
• Engages, interacts and consults with various internal contacts such as Customer Service, Legal, Client Relations, Medical Consultants, Regional Group Office and external stakeholders such as Health Practitioner Regulatory Bodies, Colleges and Associations, and Plan Sponsors
• Lead, support and implement key investigative projects
• Comfortable delivering effective presentations to new and existing clients
• Travel is required for this role, including the ability to work outside of core working hours

Where this was posted

• LinkedIn

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