Job Description
WE ARE HIRING!!
Forensic Officer
Duties and Responsibilities
Responsibilities:
* Participates in developing policies and procedures to prevent fraudulent activities and recover any incurred losses.
* Participates in planning and undertaking various statistical exercises designed to highlight over-servicing and manipulation of tariffs by service providers and members.
* Prepares monthly statistical returns on several cases under investigation.
* Alerts the Client Experience Manager on instances of system weaknesses which facilitate irregular practices and suggest methods of correcting such weaknesses.
* Investigates and prepares preliminary reports on information security and submits to the Client Experience Manager monthly.
* Carries out compliance reviews and submits a report on findings to the Client Experience Manager.
* Updates and maintains the Vulnerability Management Programme, including establishing mechanisms to identify new vulnerabilities and changes in the threat landscape.
* Research, analyse, and identify emerging global industry trends that relate to Medical Aid Fraud.
* Maintenance of the drug file system, checks, and verifies whether scheme rules are correctly loaded on the system.
* Oversees and participates in the development of analytics models to assess and identify anomalous trends relating to Medical Aid Claims and overall business operations.
* Identifies and reviews monthly claims analysis, data received from claims department and Internal Audit reports to manage anomalies.
* Oversee and participate in the development of analytic models to assess and identify anomalous trends relating to Medical Aid Claims and overall business operations.
Qualifications and Experience
Qualifications and Skills:
* A degree in Forensic Audit or Insurance and Risk Management.
* Relevant knowledge of the medical aid industry is a must.
* At least 3 years experience in a similar role.
How to Apply
Application Process:
Qualified and experienced candidates are required submit their applications together with a detailed and comprehensive CV and certified copies of educational certificates by not later than the 28th of August 2026.
Applicants should send their applications to The Human Resources Department on careers@fidelitylife.co.zw.
The post being applied for must be clearly stated in the subject line. Only shortlisted candidates will be contacted.
Fidelity Life Medical Aid Society (FLIMAS)
A Member of the ZHL Group