Description

Your Responsibilities

• Monitor claims activity, underwriting patterns, and customer behaviour for indicators of fraud, abuse, or operational anomalies.
• Develop and refine fraud detection rules, risk scoring models, and exception reporting.
• Identify fraud trends and emerging threats using AI tools, statistical analysis, and data mining.
• Support internal investigations by gathering, validating, and analyzing digital and operational evidence.
• Build proactive fraud prevention measures and operational safeguards.

• Use AI, machine learning, predictive analytics, and business intelligence platforms to improve fraud detection.
• Work with structured and unstructured data to identify correlations and behavioural anomalies.
• Build dashboards, reports, and automated monitoring for fraud and audit metrics.
• Partner with technical teams to evaluate and implement new fraud detection technologies.

• Conduct operational and process audits to identify control weaknesses and process gaps.
• Review workflows and procedures to assess compliance with company policies and regulatory requirements.
• Recommend process improvements and control enhancements to mitigate fraud and operational risk.
• Document findings, recommendations, and remediation plans.

• Partner with other divisions on fraud-related initiatives.
• Help establish fraud monitoring standards, KPIs, and reporting frameworks.
• Contribute to long-term fraud prevention strategies and AI governance practices.
• Educate internal teams on fraud indicators and prevention practices.

Your Qualifications

• Has an investigative mindset and superior attention to detail.
• Has professional written and verbal communication skills.
• Can translate complex data for any audience.
• Thrives in a busy environment and enjoys performing a wide range of tasks.
• Applies a high level of critical, analytical, and logical thinking.
• Uses sound judgement and ethical reasoning to make decisions and take calculated risks.
• Adapts well to, and often initiates, change.
• Enjoys personal development and growth through learning.
• Provides and receives constructive feedback.

• A Bachelor of Accounting, Business, Commerce, or equivalent.
• At least 5 years of experience in fraud analysis, auditing, risk management, insurance operations, data analytics, or investigations.
• At least 3 years of experience working with large datasets and reporting tools.
• Familiarity with AI, machine learning, or predictive analytics tools.
• Working knowledge of SQL, Power BI, Tableau, Python, R, or similar analytics platforms.
• A professional certification such as CFE (Certified Fraud Examiner), CIA (Certified Internal Auditor), CIP or FCIP, or a data analytics/AI credential.

Your Compensation + Benefits

• A competitive base salary, commensurate with experience.
• 4-weeks, not 3-weeks, of vacation to start and an additional week after only 3 years.
• The ability to work from home.
• Flexible medical, dental, vision and extended health care coverage.
• Short and long-term disability coverage.
• Participation in the corporate profit-sharing and performance bonus plans.

About Square One Insurance Services