We are seeking a seasoned Forensic Specialists to be part of the Fraud Monitoring Unit to handle investigation of complex frauds. This role demands cross-industry expertise, advanced forensic audit capabilities (including digital data analytics), and the ability to engage effectively with external stakeholders such as enforcement agencies, hospitals, distributors, and regulators. The successful candidate will play a critical role in strengthening fraud resilience, ensuring compliance, and protecting organizational integrity.

Key Result Areas:

Fraud Investigation & Case Management:

- Direct complex investigations into suspected fraud cases, ensuring thorough documentation and evidence preservation.

- Collaborate with internal audit, compliance, and legal teams to drive resolution and recommend corrective actions.

- Present findings to senior leadership with actionable insights for fraud prevention.

Forensic Audits & Digital Data Analysis:

- Lead forensic audits across life insurance operations, focusing on claims, underwriting, and distribution channels.

- Utilize advanced digital forensic tools to analyze structured and unstructured data, detect anomalies, and identify fraud patterns.

- Conduct deep-dive audits into digital records, transaction logs, and communication trails to uncover hidden fraud risks.

- Develop and maintain digital evidence protocols to ensure admissibility in regulatory or legal proceedings.

- Be proactive and use analytical capabilities to find concentrations and investigate any concerns noted.

External Stakeholder Engagement:

- Manage high-level meetings and collaborations with enforcement agencies, hospitals, distributors, and other external stakeholders.

- Build strong networks with regulators, law enforcement, and industry associations to share intelligence and strengthen fraud deterrence.

- Act as the company's representative in external forums, investigations, and cross-industry fraud prevention initiatives.

Cross-Industry Expertise:

- Apply fraud management practices from banking, healthcare, fintech, and other industries to enhance insurance fraud detection frameworks.

- Benchmark and implement best practices in forensic auditing and fraud risk management.

Leadership & Strategy:

- Provide strategic direction to the Fraud Management Unit, mentoring junior investigators and auditors.

- Drive continuous improvement in fraud detection methodologies, leveraging technology and analytics.

- Develop fraud risk assessment models tailored to life insurance products and services.

Reporting & Compliance:

- Prepare detailed forensic audit reports for senior management, regulators, and legal proceedings.

- Ensure compliance with regulatory requirements, industry standards, and company policies.

- Maintain confidentiality and integrity in all investigative processes.

Skills Required:

Technical:

- Bachelor's degree in Accounting, Finance, Law, Criminology, or related field; advanced degree preferred.

- Professional certifications such as CFE (Certified Fraud Examiner) or a recognised institution is a must.

- Professional certifications is CISA, CPA, CAMS, or CFA highly desirable.

- Overall experience of 12+ years with minimum 10 years of experience in forensic audits, fraud management, or risk management with at least 5 years in leadership roles.

- Proven cross-industry experience (e.g.NBFC / Banking, healthcare, fintech, Insurance).

- Strong knowledge of life insurance operations, fraud typologies, and regulatory frameworks.

- Expertise in digital forensic tools, data analytics, and audit methodologies.

- Exceptional communication and stakeholder management skills.