FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Investigator, Fraud Risk Management
Sun LifeInvestigator responsible for fraud detection and prevention in health care benefits at Sun Life. Conducting investigations and collaborating with teams to mitigate fraud threats across Canada.
About the role
Key responsibilities & impact- Investigate situations of fraud and/or abuse with a focus on medical providers and facilities
- Conduct plan member and service provider interviews
- Respond to inquiries and escalations
- Maintain all databases and logs pertaining to Investigations
- Prepare and participate in court/complaint cases to resolve investigations
- Research, gather data, prepare and organize documentation for plan sponsors, police and management
- Identify trends, report on issues and suggest appropriate actions to both internal and external clients
- Perform on-site audits of service providers.
Requirements
What you’ll need- Previous audit / investigation / banking and interviewing experience
- Knowledge of group insurance business and regulatory environment
- Understanding of contractual language, administration guidelines, and provincial and federal legislation applicable to the industry
- Knowledge of medical terminology
- University degree or postsecondary education is an asset
- Bilingualism (French, English, both oral and written) is required for Quebec only.
Benefits
Comp & perks- Access to short-term assignments or ‘Gigs’ across the organization, to help you develop new skills and connections.
- A collaborative and interactive team environment
- Charitable giving through our You Give, We Give program lets you give back to your community – and in many cases, we’ll match your contributions.
- Care Days available for self-care or care of others (i.e., family or others you may support) and Sick Days to support your well-being.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
audit experienceinvestigation experiencebanking experienceinterviewing experienceknowledge of group insuranceknowledge of medical terminologyunderstanding of contractual languageadministration guidelinesprovincial legislationfederal legislation
Soft Skills
communication skillsanalytical skillsorganizational skillsproblem-solving skillsinterpersonal skills
Certifications
university degreepostsecondary education