Compliance Specialist

Req ID: 330132 

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a Compliance Specialist to join our team.

Insurance Compliance Specialist

This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short- and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

This position assists and supports the organization in complying with, as well as the ongoing preparation, testing and monitoring of conformance to, the requirements of State and Federal Fraud Regulations and/or regulatory agencies. Performs evaluation of internal operations, controls, communications, assessments, and maintenance of documentation as related to fraud regulatory compliance and recommends appropriate changes. Monitors and analyzes potential frauds and escalates to the Client carries for review and reporting. Preferred Certified Fraud Examiner Certification.

Pay for this role is $60,500/yr

 Basic Qualifications:

• 3 years’ experience designing and implementing anti-fraud controls.
• 3 years’ experience assessing fraud risks, e.g., performing risk assessments.
• 1 years’ insurance experience.

Responsibilities:

• Lead the Fraud program and provide guidance and feedback on Fraud risks associated with Insurance policies.
• This encompasses, but is not limited to, updating the company’s anti-fraud plan and ensuring the program complies with all applicable U.S. Federal and State requirements.
• Detecting, reviewing, and logging of suspected fraudulent activity based on client contractual requirements.
• This involves drafting detailed summaries that outline the fraud concern, identify process gaps and associated risks, and communicate these findings to the client in accordance with contractual obligations. It may also include contacting U.S. regulatory agencies to fulfill any reporting requirements.
• Escalating suspected fraud activity to Clients and assisting with questions. o NTT has strict contractual reporting obligations that often require a 24 hour SLA reporting suspected fraud cases to the clients SIU.
• Working with Clients and assisting with internal audits that are sent to Compliance in relation to fraud processing and escalations. o NTT has strict SLAs on gathering the data and providing the documentation to the internal audit department. The position requires someone to understand the documentation and what should be provided as part of an audit.
• Work with other Compliance team members to create projects based on suspected fraud activity.
• Draft, maintain, prepare documents such as procedures, job aids, and matrices.
• The individual should have strong attention to detail, organizational skills, and the ability to collaborate with various teams to ensure documentation remains accurate and effective.
• Create and review Insurance Fraud Related 50 State Charts and Contract Reviews. This would encompass all insurance related processes that pertain to specific laws and regulations that are to be supported by insurers, third party administrators, producers, etc.
• Monitors functional and operational areas for compliance risks related to State and Federal Fraud Regulation. o The individual in this role should possess a strong research background and the ability to deliver quick, concise results, as the SLAs require fast-paced analysis.
• Able to make independent decisions that have a significant impact on strategic direction.
• Provide regulatory compliance expertise whenever needed.
• Cross trained in AML review and Privacy reviews. o NTT has strict contractual reporting obligations that often require a 24 hour SLA reporting suspected privacy cases to the Insurer. SLA mandate fast-paced results.
• Maintain, prepare other compliance documents or agreements as needed.
• Preferred Certified Fraud Examiner Certification

***Required schedule availability for this position is Monday-Friday (8:00am to 5:00pm CST). Shift times may be changed as per client requirements. Additionally, Overtime may be required based on business requirements.

Must Pass Drug screen

Must Pass a background check with Education check and employment verification check. 

Remote Working and Technology Requirements

To work remote, individuals must meet all the established Remote requirements including those pertaining to a home workspace and related technology.

Technology

• NTT DATA will provide a computer and headset for remote work.
• Employees are responsible for the care and security of all equipment provided. They must return it immediately upon separation from the company following company protocols.
• Failure to return equipment may result in collection actions and/or other consequences.
• Individuals must provide their own high speed internet access with speeds at or above 50 Mbps.
• A hard-wired ethernet connection is required. Wi-Fi, mobile, wireless and public internet connections are forbidden as are connections outside of one’s personal dwelling or location.

Technical Performance and Issue Tracking

• Management monitors all technical issues and agent downtime. Consistent availability is critical to business operations.
• Remote employees must adhere to all technical support procedures and protocols.
• Chronic connectivity issues or recurring downtime that impede job performance, including internet outages, may result in the remote status changing to onsite.

Remote Workspace

Remote work demands a high degree of professionalism, self-discipline, and accountability. The following workspace standards are vital to delivering exceptional service.

• Employees must have a dedicated, professional workspace conducive to servicing Customer Service customers with the same quality as an onsite environment.
• The workspace must be a permanent, unencumbered location used daily for work.
• Employees must work with minimal distractions that do not interfere with business operations or service delivery.
• Ideally, the workspace is isolated from other household members and used exclusively for job duties.
• Background noise, interruptions from people or pets, and other distractions must be kept to an absolute minimum to avoid disruptions to customer service.
• Employees must work from the same location consistently unless prior approval is obtained.
• If a change in work location is necessary:
• The new location must meet all Remote Workspace and Technology Requirements.
• Notification to NTT DATA Management is required before relocating

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About NTT DATA

NTT DATA is a $30 billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize and transform for long term success. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com

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