About the role

Investigation Advisor investigating health and dental claim fraud for iA Financial Group. Analyzing suspicious patterns, documenting findings, and improving fraud-detection tools.

Responsibilities

Review referrals and information regarding suspected fraud or abuse related to health and dental claims
Analyze fraud-detection alerts and conduct independent data analysis to identify suspicious patterns and potentially fraudulent activity
Prioritize investigative efforts based on risk level, financial exposure, and expected value
Conduct thorough investigations by gathering evidence from plan members, service providers, internal systems, and other relevant sources
Maintain objectivity throughout investigations
Document findings, develop recommendations, and prepare reports for clients
Partner with analytics teams to enhance alert quality and improve fraud-detection mechanisms
Recommend enhancements to detection rules, scenarios, and tool parameters based on investigation outcomes and frontline observations
Contribute to continuous improvement of investigation processes, tools, and practices
Manage escalated cases professionally and ensure thorough follow-up
Promote fraud prevention among internal and external stakeholders through awareness initiatives and strategic recommendations
Keep current on emerging fraud trends, schemes, and industry best practices

3 to 5 years of experience in auditing, investigations, insurance, healthcare, or financial services
Strong analytical and critical thinking skills
Ability to navigate uncertainty and exercise sound professional judgment in ambiguous or incomplete situations
Proficiency in data analysis and interpretation
Experience using analytical tools
Ability to review large volumes of transactional data
Discretion and professionalism when handling sensitive information
Excellent communication and interpersonal skills
Ability to manage difficult conversations professionally
Strong writing skills for clear, objective, and well-documented reports
Ability to manage multiple investigations simultaneously
Ability to adapt to changing priorities in a fast-paced environment
Ability to work independently and collaboratively
Strong sense of accountability and initiative
Fully proficient in French
Advanced level of English
Regular communication with internal and external clients across Canada

A work environment where learning and development merge with a collective pursuit of excellence
A healthy, safe, fair, and inclusive environment where potential can be freely expressed and developed
Hybrid work environment with flexibility and access to inspiring and innovative workspaces
Flexible group insurance
Competitive pension plan
Stock purchase plan
Vacation and wellness/personal development days
Telemedicine
Employee and family assistance program
Ergonomic furniture program
Performance bonus
Discounts on iA products