Fraud Specialist

JOB PURPOSE:

The Fraud Specialist will lead the implementation and continuous enhancement of the Company's Anti-Fraud Plan and/or Anti-Fraud Management Program by overseeing fraud prevention, detection, investigation, and enforcement activities in consideration of business operations. As a people manager, the role provides strategic direction and operational oversight to a team of investigators, ensuring timely, accurate, and compliant investigative services that protect the Company's assets and uphold stakeholder trust.

The role is instrumental in safeguarding the integrity of underwriting and claims processes by validating the veracity of information provided by policyholders, insureds, claimants, and beneficiaries. It also addresses misconduct in sales and distribution, and servicing operations by investigating complaints against agents and employees for violations of laws, regulatory issuances—including Market Conduct Guidelines—and internal policies such as the Code of Business Conduct and Employee Code of Conduct.

PRINCIPAL ACCOUNTABILITIES:

• Identify and address fraud vulnerabilities through structured risk assessments and control evaluations.
• Ensure the consistent application of fraud prevention mechanisms in various operations by embedding internal controls and promoting ethical practices.
• Conduct or coordinate investigations to validate suspected fraud incidents and recommend appropriate actions.
• Promote a culture of integrity and fraud awareness through continuous education and engagement.
• Coordinate with external partners and regulators, and lead recovery and enforcement efforts in fraud-related losses.

THE IDEAL CANDIDATE FOR THE ROLE:

• Possess a degree in Accounting, Information Technology (IT), or Business Process Engineering. Special designations such as Certified Public Accountant (CPA) or Certified Fraud Examiner (CFE) are a significant advantage.
• A minimum of five (5) years of relevant work experience in audit, investigations, risk management, or compliance is required. Direct professional experience in anti-fraud initiatives (prevention, detection, and investigation) is highly advantageous.
• Background and/or working knowledge on insurance company operations will be an advantage.
• Possesses the maturity and credibility required to effectively engage with senior management and manage sensitive issues.
• Proven ability to identify, evaluate, and interpret complex financial transactions using appropriate financial accounting records.
• Knowledge in data analytics, computer forensics, and information security is preferred.
• Willingness to travel as required and the ability to act on own initiative with minimal supervision.
• Self-confident, self-motivated, and possessing strong interpersonal skills to establish and maintain professional working relationships.
• Proven ability to work effectively under pressure and meet milestones within established timelines.
• Must be willing to work in Alabang, Muntinlupa.