Especialista Fraude Operativo

About the role

The Operational Fraud Specialist will design and implement internal control methods, detection, prevention and investigation processes to protect the organization from fraud‑related losses, particularly within health‑related operations.

Key responsibilities

• Design and implement internal control procedures for fraud detection and prevention.
• Measure fraud risk exposure by monitoring relevant areas and matrices.
• Manage fraud risk using proven methodologies to ensure timely detection.
• Develop and implement fraud management indicators.
• Conduct investigations of fraudulent activities using appropriate investigative techniques.
• Implement deterrence measures to reduce fraud incidence.
• Train staff on fraud detection, handling and prevention practices.

Required profile

• University degree in Administration, Law, Industrial Engineering or a related field.
• Strong knowledge of health processes such as operations and authorizations.
• Specialization in fraud detection, handling and investigation (preferred).
• At least three years of experience in fraud detection or investigation (preferred).
• Familiarity with the health insurance sector.

Required skills