Counter Fraud Specialist at Britam

Job Purpose:

• The Counter Fraud Specialist is responsible for all facets of fraud prevention, detection, investigation and remediation within the Britam. 
• The jobholder is responsible for investigations into allegations of fraud, in accordance with key legislation and company policies, and deliver proactive counter fraud reviews in relation to the adequacy and effectiveness of internal controls and their ability to prevent, detect and deter fraud. Investigations and reviews assigned will be in complex and/or medium risk areas.
• CFS’s will be required to provide support and advice to managers on the most efficient ways of pursuing investigations and implementing recommendations.

Key responsibilities:

• Undertaking fraud investigations of cases reported to the Group Forensics team from various sources including whistleblowing hotline, customer escalations, letters to Management, Internal Audits, direct tip offs etc.
• Evaluate potential fraud indicators and the impact of current fraud trends and make recommendations as to appropriate mitigation.
• Conducting investigations into allegations of fraud, waste or abuse committed against the Organization. 
• Preparing and coordinating field assignments to obtain relevant evidence and information.
• Conduct objective, fair, thorough, unbiased and timely investigations into allegations of fraud, waste or abuse committed against the Organization.
• Participate in formulating and implementing a comprehensive Fraud Risk Management framework within the Corporate Segment.  
• Applying theories, concepts and approaches relevant to administrative investigations.
• Applying various research methodologies and sources as required in investigations, including using electronic sources on the Internet, intranet and other databases. 
• Reporting fraud cases to IRA or Police to facilitate prosecution of agents, staff or other Britam stakeholders involved in fraudulent business practices and giving evidence in Court.
• Maintaining a database of cases received and regularly and assist in preparation of Management, Board and other relevant reports and statistics as required.
• Propose, discuss and agree recommendations to improve control weaknesses identified during investigations and regularly follow up for their implementation.
• Managing and strengthening bonds with law enforcement agencies and other Industry & non-industry players to enhance co-operation on mutually beneficial information, fraud investigations, asset tracing & recovery etc.
• Conducting anti-fraud awareness training to various stakeholders.

Key Performance Measures:
As described in your Personal Score Card.

Working Relationships:

Internal Relationships:

The Investigations Associate will be;

• Responsible to the the Head of Fraud & Forensics.
• Working with all Operations Departments in the retail segment.

External Relationships:

• Britam Clients.
• Bancassurance Partners.
• Insurance sector players.

Knowledge, experience and qualifications required

Knowledge, experience and qualifications required:

• A degree from a recognized university.
• Certified Fraud Examiner (or equivalent).
• 4 years’ experience in criminal or administrative investigations; preferably in the insurance industry.
• Knowledge of business operations, fraud investigations, prosecution process including preparation of evidence.
• Knowledge of theories, concepts and approaches relevant to criminal and administrative investigations. 
• Knowledge of various research methodologies and sources, including electronic sources on the Internet, intranet and other databases.

Technical/ Functional competencies:

• Knowledge of insurance regulatory requirements.
• Knowledge of insurance products.
• Sales and marketing management skills.

Leadership category responsibility framework (Core Competencies):

Team Leaders in Britam need to:

• Operationally lead a team to service customers from a sustainable and growing customer base whilst increasing profit.
• Ensure the company’s objectives are met by being a vision carrier and by implementing strategy and operational outputs.
• Effectively run the business and manage staff in order to enable functional leaders to focus on developing strategy.
• Effectively identify and define key performance areas, deadlines and goals for their team in order to optimise operational effectiveness.
• Ensure the department has the most appropriate people capability through effective inspirational leadership, people development, effective selection and optimised succession planning.
• Create a high performance, proactive culture and motivated team.
• Monitor operational implementation, budgets, plans, goals and outputs in order to ensure alignment with the departmental strategy.
• Ensure that department priorities are adhered to and effectively communicated.
• Effectively disseminate knowledge within the correct context, towards subordinates as well as management.
• Appropriately model the company values while setting the pace and energy for delivering.
• Benchmark operational activities internally as well as externally in order to be a leader in the industry.
• Effectively manage and communicate change within the department in order to increase staff and process effectiveness.
• Provide access to accurate and consistent information and services across all channels.
• Adequately manage operational risk.