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| fraud case management system: Real-time Fraud Detection Analytics on IBM System z Mike Ebbers, Dheeraj Reddy Chintala, Priya Ranjan, Lakshminarayanan Sreenivasan, IBM Redbooks, 2013-04-11 Payment fraud can be defined as an intentional deception or misrepresentation that is designed to result in an unauthorized benefit. Fraud schemes are becoming more complex and difficult to identify. It is estimated that industries lose nearly $1 trillion USD annually because of fraud. The ideal solution is where you avoid making fraudulent payments without slowing down legitimate payments. This solution requires that you adopt a comprehensive fraud business architecture that applies predictive analytics. This IBM® Redbooks® publication begins with the business process flows of several industries, such as banking, property/casualty insurance, and tax revenue, where payment fraud is a significant problem. This book then shows how to incorporate technological advancements that help you move from a post-payment to pre-payment fraud detection architecture. Subsequent chapters describe a solution that is specific to the banking industry that can be easily extrapolated to other industries. This book describes the benefits of doing fraud detection on IBM System z®. This book is intended for financial decisionmakers, consultants, and architects, in addition to IT administrators. |
| fraud case management system: Warranty Fraud Management Matti Kurvinen, Ilkka Töyrylä, D. N. Prabhakar Murthy, 2016-05-26 Cut warranty costs by reducing fraud with transparent processes and balanced control Warranty Fraud Management provides a clear, practical framework for reducing fraudulent warranty claims and other excess costs in warranty and service operations. Packed with actionable guidelines and detailed information, this book lays out a system of efficient warranty management that can reduce costs without upsetting the customer relationship. You'll dig into the whole spectrum of warranty fraud, from simple sloppy procedures to systematic organized crime, and get to know the fraudulent parties, the victims, as well as the objectives and methods of the fraudulent activities in different scenarios. You'll learn how to implement controls to detect and reduce fraudulent claims and decrease the overall warranty costs. The impact of fraudulent claims is plainly spelled out alongside detailed descriptions of typical symptoms and process gaps present in diverse companies. A comprehensive, multi-modal framework for robust warranty management is presented as a template for revamping your own company's strategy. Fraudulent warranty claims occupy an estimated 3-15 percent of the average company's warranty costs, which generally average between 1-4 percent of sales. Many companies are unaware of the issue or struggle to take action against the claims for fear of upsetting business partners, or because they lack tangible evidence. This book details a robust warranty control framework that institutes transparency and control over the whole warranty chain—supporting the process far beyond just fraud reduction. Understand the different actors (customers, sales channels, service agents, warranty providers, etc.) and different forms of warranty fraud Uncover issues in your company's warranty processes Learn methods to detect and prevent fraudulent activities Implement a robust system of warranty cost control Warranty fraud is a major cost-control issue for most companies, but the sensitive nature of the topic leaves most reluctant to share their experiences and divulge their strategies. Warranty Fraud Management brings warranty fraud out into the open, and provides a clear, actionable framework for cost-savings through fraud reduction. |
| fraud case management system: Fraud Analytics with SAS , 2019-06-21 SAS software provides many different techniques to monitor in real time and investigate your data, and several groundbreaking papers have been written to demonstrate how to use these techniques. Topics covered illustrate the power of SAS solutions that are available as tools for fraud analytics, highlighting a variety of domains, including money laundering, financial crime, and terrorism. Also available free as a PDF from: sas.com/books. |
| fraud case management system: Computer Aided Fraud Prevention and Detection David Coderre, 2009-03-17 Praise for Computer-Aided Fraud Prevention and Detection: A Step-by-Step Guide A wonderful desktop reference for anyone trying to move from traditional auditing to integrated auditing. The numerous case studies make it easy to understand and provide a how-to for those?seeking to implement automated tools including continuous assurance. Whether you are just starting down the path or well on your way, it is a valuable resource. -Kate M. Head, CPA, CFE, CISA Associate Director, Audit and Compliance University of South Florida I have been fortunate enough to learn from Dave's work over the last fifteen years, and this publication is no exception. Using his twenty-plus years of experience, Dave walks through every aspect of detecting fraud with a computer from the genesis of the act to the mining of data for its traces and its ultimate detection. A complete text that first explains how one prevents and detects fraud regardless of technology and then shows how by automating such procedures, the examiners' powers become superhuman. -Richard B. Lanza, President, Cash Recovery Partners, LLC Computer-Aided Fraud Prevention and Detection: A Step-by-Step Guide helps management and auditors answer T. S. Eliot's timeless question, 'Where is the knowledge lost in information?' Data analysis provides a means to mine the knowledge hidden in our information. Dave Coderre has long been a leader in educating auditors and others about Computer Assisted Audit Techniques. The book combines practical approaches with unique data analysis case examples that compel the readers to try the techniques themselves. -Courtenay Thompson Jr. Consultant, Courtenay Thompson & Associates |
| fraud case management system: Fraud Analysis Techniques Using ACL David Coderre, 2009-07-23 When people ask me what they can do to better utilize ACL, I tell them, 'Take an instructor lead course, participate in the ACL Forum, and study (not read, study) David Coderre's Fraud Analysis Techniques Using ACL.' I studied this book, and would not be where I am today without it. Even without the anti-fraud material, the book is worth the investment as a tool to learning ACL! —Porter Broyles, President and founder of the Texas ACL User Group, Keynote Speaker at ACL's 2009 San Francisco Conference, Official ACL Super User For individuals interested in learning about fraud analysis techniques or the art of ACL scripting, this book is a must-read. For those individuals interested in learning both, this book is a treasure. —Jim Hess, Principal, Hess Group, LLC Your very own ACL Fraud Toolkit—at your fingertips Fraud Analysis Techniques Using ACL offers auditors and investigators: Authoritative guidance from David Coderre, renowned expert on the use of computer-assisted audit tools and techniques in fraud detection A website containing an educational version of ACL from the world leader in fraud detection software An accompanying website containing a thorough Fraud Toolkit with two sets of customizable scripts to serve your specific audit needs Case studies and sample data files that you can use to try out the tests Step-by-step instructions on how to run the tests A self-study course on ACL script development with exercises, data files, and suggested answers The toolkit also contains 12 'utility scripts' and a self-study course on ACL scripting which includes exercises, data files, and proposed answers. Filled with screen shots, flow charts, example data files, and descriptive commentary highlighting and explaining each step, as well as case studies offering real-world examples of how the scripts can be used to search for fraud, Fraud Analysis Techniques Using ACL is the only toolkit you will need to harness the power of ACL to spot fraud. |
| fraud case management system: The International Corporate Governance System F. Lessambo, 2016-01-26 This book provides a comprehensive approach to Corporate Governance, Audit Process and Risk Management. Furthermore, it provides an analytical and comprehensive approach of the issues facing governance directors, internal and external auditors, risk managers, and public officials conducting assessments based upon the Report on Standards and Codes. |
| fraud case management system: Corporate Fraud Handbook Joseph T. Wells, 2017-05-01 Delve into the mind of a fraudster to beat them at their own game Corporate Fraud Handbook details the many forms of fraud to help you identify red flags and prevent fraud before it occurs. Written by the founder and chairman of the Association of Certified Fraud Examiners (ACFE), this book provides indispensable guidance for auditors, examiners, managers, and criminal investigators: from asset misappropriation, to corruption, to financial statement fraud, the most common schemes are dissected to show you where to look and what to look for. This new fifth edition includes the all-new statistics from the ACFE 2016 Report to the Nations on Occupational Fraud and Abuse, providing a current look at the impact of and trends in fraud. Real-world case studies submitted to the ACFE by actual fraud examiners show how different scenarios play out in practice, to help you build an effective anti-fraud program within your own organization. This systematic examination into the mind of a fraudster is backed by practical guidance for before, during, and after fraud has been committed; you'll learn how to stop various schemes in their tracks, where to find evidence, and how to quantify financial losses after the fact. Fraud continues to be a serious problem for businesses and government agencies, and can manifest in myriad ways. This book walks you through detection, prevention, and aftermath to help you shore up your defenses and effectively manage fraud risk. Understand the most common fraud schemes and identify red flags Learn from illustrative case studies submitted by anti-fraud professionals Ensure compliance with Sarbanes-Oxley and other regulations Develop and implement effective anti-fraud measures at multiple levels Fraud can be committed by anyone at any level—employees, managers, owners, and executives—and no organization is immune. Anti-fraud regulations are continually evolving, but the magnitude of fraud's impact has yet to be fully realized. Corporate Fraud Handbook provides exceptional coverage of schemes and effective defense to help you keep your organization secure. |
| fraud case management system: Bank Fraud Revathi Subramanian, 2014-04-14 Learn how advances in technology can help curb bank fraud Fraud prevention specialists are grappling with ever-mounting quantities of data, but in today's volatile commercial environment, paying attention to that data is more important than ever. Bank Fraud provides a frank discussion of the attitudes, strategies, and—most importantly—the technology that specialists will need to combat fraud. Fraudulent activity may have increased over the years, but so has the field of data science and the results that can be achieved by applying the right principles, a necessary tool today for financial institutions to protect themselves and their clientele. This resource helps professionals in the financial services industry make the most of data intelligence and uncovers the applicable methods to strengthening defenses against fraudulent behavior. This in-depth treatment of the topic begins with a brief history of fraud detection in banking and definitions of key terms, then discusses the benefits of technology, data sharing, and analysis, along with other in-depth information, including: The challenges of fraud detection in a financial services environment The use of statistics, including effective ways to measure losses per account and ROI by product/initiative The Ten Commandments for tackling fraud and ways to build an effective model for fraud management Bank Fraud offers a compelling narrative that ultimately urges security and fraud prevention professionals to make the most of the data they have so painstakingly gathered. Such professionals shouldn't let their most important intellectual asset—data—go to waste. This book shows you just how to leverage data and the most up-to-date tools, technologies, and methods to thwart fraud at every turn. |
| fraud case management system: Fraud Analytics Using Descriptive, Predictive, and Social Network Techniques Bart Baesens, Veronique Van Vlasselaer, Wouter Verbeke, 2015-08-17 Detect fraud earlier to mitigate loss and prevent cascading damage Fraud Analytics Using Descriptive, Predictive, and Social Network Techniques is an authoritative guidebook for setting up a comprehensive fraud detection analytics solution. Early detection is a key factor in mitigating fraud damage, but it involves more specialized techniques than detecting fraud at the more advanced stages. This invaluable guide details both the theory and technical aspects of these techniques, and provides expert insight into streamlining implementation. Coverage includes data gathering, preprocessing, model building, and post-implementation, with comprehensive guidance on various learning techniques and the data types utilized by each. These techniques are effective for fraud detection across industry boundaries, including applications in insurance fraud, credit card fraud, anti-money laundering, healthcare fraud, telecommunications fraud, click fraud, tax evasion, and more, giving you a highly practical framework for fraud prevention. It is estimated that a typical organization loses about 5% of its revenue to fraud every year. More effective fraud detection is possible, and this book describes the various analytical techniques your organization must implement to put a stop to the revenue leak. Examine fraud patterns in historical data Utilize labeled, unlabeled, and networked data Detect fraud before the damage cascades Reduce losses, increase recovery, and tighten security The longer fraud is allowed to go on, the more harm it causes. It expands exponentially, sending ripples of damage throughout the organization, and becomes more and more complex to track, stop, and reverse. Fraud prevention relies on early and effective fraud detection, enabled by the techniques discussed here. Fraud Analytics Using Descriptive, Predictive, and Social Network Techniques helps you stop fraud in its tracks, and eliminate the opportunities for future occurrence. |
| fraud case management system: Forensic Accounting and Fraud Examination Mary-Jo Kranacher, Richard Riley, Joseph T Wells, 2010-06-08 Forensic Accounting provides comprehensive coverage of fraud detection and deterrence and includes the broader educational material of the forensic accounting field with all the necessary accompaniments. The text follows the model curriculum for education in fraud and forensic funded by the U.S. national Institute of Justice and developed by a Technical Working Group of experts in the field. The text serves as a comprehensive and authoritative resource for teaching forensic accounting concepts and procedures that is also and appropriate and pedagogically ready for class room use. This easy to read, comprehensive textbook includes case study examples to clearly explain technical concepts and bring the material to life. |
| fraud case management system: Fraud Risk Assessment Tommie W. Singleton, Aaron J. Singleton, 2011-04-12 Praise for the Fourth Edition of Fraud Auditing and Forensic Accounting Tommie and Aaron Singleton have made important updates to a book I personally rely very heavily upon: Fraud Auditing and Forensic Accounting (FAFA). In the newest edition, they take difficult topics and explain them in straightforward actionable language. All my students benefitted from reading the third edition of the FAFA to better understand the issues and area of fraud and forensic accounting. With their singular focus on understandability and practicality, this Fourth Edition of the book makes a very important contribution for academics, researchers, practitioners, and students. Bravo!—Dr. Timothy A. Pearson, Director, Division of Accounting, West Virginia University, Executive Director, Institute for Fraud Prevention Finally someone has written a book that combines fraud examination and forensic accounting. The authors have clearly explained both in their earlier edition and now they have enhanced the first with additional materials. The order in which the material is presented is easy to grasp and logically follows the 'typical' fraud examination from the awareness that something is wrong to the court case. The explanatory materials presented aid this effort by being both well placed within the book and relevant to the narrative. —Dr. Douglas E. Ziegenfuss, Chair and Professor, Department of Accounting, Old Dominion University Fraud Auditing and Forensic Accounting is a masterful compilation of the concepts found in this field. The organization of the text with the incorporation of actual cases, facts, and figures provides a logical and comprehensive basis for learning the intricacies of fraud examination and forensic accounting. The authors successfully blend the necessary basics with advanced principles in a manner that makes the book an outstanding resource for students and professionals alike.—Ralph Q. Summerford, President of Forensic/Strategic Solutions, PC |
| fraud case management system: Standards for Internal Control in the Federal Government United States Government Accountability Office, 2019-03-24 Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government. |
| fraud case management system: Principles of Fraud Examination Joseph T. Wells, 2014-04-21 Accountants have historically had an important role in the detection and deterrence of fraud. As Joe Wells’ Principles of Fraud Examination 4th edition illustrates, fraud is much more than numbers; books and records don’t commit fraud – people do. Widely embraced by fraud examination instructors across the country, Principles of Fraud Examination, 4th Edition, by Joseph Wells, is written to provide a broad understanding of fraud to today’s accounting students – what it is and how it is committed, prevented, detected, and resolved. This 4th edition of the text includes a chapter on frauds perpetrated against organizations by individuals outside their staff—a growing threat for many entities as commerce increasingly crosses technological and geographical borders. |
| fraud case management system: Progress in tackling benefit fraud Great Britain: National Audit Office, 2008-01-23 This NAO report is a follow up to one issued in the 2002-03 session (HC 393, ISBN 9780102920635), Tackling Benefit Fraud. The report sets out some key facts, including: that the total benefit expenditure is £120 billion; the total number of recipients is 18 million; the total estimated fraud is £0.8 billion. In the 2006-07 period, £154 million was spent on six strategies to reduce fraud, with a Departmental estimate of £106 million of benefit overpayments identified as a result of fraud investigation and compliance activity. Also in the 2006-07 period, the Department recovered £22 million of the total £339 million outstanding fraud debt. Although the NAO has identified that fraud has fallen from an estimated £2 billion in 2001-02 to an estimated £0.8 billion in 2006-07, official error has risen in the same period from £1 billion to £1.9 billion. Tackling fraud is a key priority for the Department for Work and Pensions, and the report examines the main anti-fraud initiatives, recognising that: tackling benefit is inherently difficult; that the UK has levels of social security fraud and error which are similar to those of comparable countries; that the Department has made good progress in tackling fraud, but will find it increasingly difficult to secure further year on year reductions. The NAO has also set out a number of recommendations, including: that the Department's management information on fraud could be improved, with greater communication between the various departmental directorates responsible for counter-fraud work; that a review of the cost effectiveness of the Customer Compliance approach (which deals with lower risk cases of fraud) should be done; that a record of the outcomes of prosecution activities should be taken by case type to provide better Departmental information; that the Department must review recovery of overpayments in fraud cases and consider setting appropriate targets for recovery from customers who have committed fraud. |
| fraud case management system: Oversight of the U.S. Department of Justice United States. Congress. Senate. Committee on the Judiciary, 2012 |
| fraud case management system: Risk-Based Monitoring and Fraud Detection in Clinical Trials Using JMP and SAS Richard C. Zink, 2014-07-01 Improve efficiency while reducing costs in clinical trials with centralized monitoring techniques using JMP and SAS. International guidelines recommend that clinical trial data should be actively reviewed or monitored; the well-being of trial participants and the validity and integrity of the final analysis results are at stake. Traditional interpretation of this guidance for pharmaceutical trials has led to extensive on-site monitoring, including 100% source data verification. On-site review is time consuming, expensive (estimated at up to a third of the cost of a clinical trial), prone to error, and limited in its ability to provide insight for data trends across time, patients, and clinical sites. In contrast, risk-based monitoring (RBM) makes use of central computerized review of clinical trial data and site metrics to determine if and when clinical sites should receive more extensive quality review or intervention. Risk-Based Monitoring and Fraud Detection in Clinical Trials Using JMP and SAS presents a practical implementation of methodologies within JMP Clinical for the centralized monitoring of clinical trials. Focused on intermediate users, this book describes analyses for RBM that incorporate and extend the recommendations of TransCelerate Biopharm Inc., methods to detect potential patient-or investigator misconduct, snapshot comparisons to more easily identify new or modified data, and other novel visual and analytical techniques to enhance safety and quality reviews. Further discussion highlights recent regulatory guidance documents on risk-based approaches, addresses the requirements for CDISC data, and describes methods to supplement analyses with data captured external to the study database. Given the interactive, dynamic, and graphical nature of JMP Clinical, any individual from the clinical trial team - including clinicians, statisticians, data managers, programmers, regulatory associates, and monitors - can make use of this book and the numerous examples contained within to streamline, accelerate, and enrich their reviews of clinical trial data. The analytical methods described in Risk-Based Monitoring and Fraud Detection in Clinical Trials Using JMP and SAS enable the clinical trial team to take a proactive approach to data quality and safety to streamline clinical development activities and address shortcomings while the study is ongoing. This book is part of the SAS Press |
| fraud case management system: Fraud and Fraud Detection, + Website Sunder Gee, 2014-12-03 Detect fraud faster—no matter how well hidden—with IDEA automation Fraud and Fraud Detection takes an advanced approach to fraud management, providing step-by-step guidance on automating detection and forensics using CaseWare's IDEA software. The book begins by reviewing the major types of fraud, then details the specific computerized tests that can detect them. Readers will learn to use complex data analysis techniques, including automation scripts, allowing easier and more sensitive detection of anomalies that require further review. The companion website provides access to a demo version of IDEA, along with sample scripts that allow readers to immediately test the procedures from the book. Business systems' electronic databases have grown tremendously with the rise of big data, and will continue to increase at significant rates. Fraudulent transactions are easily hidden in these enormous datasets, but Fraud and Fraud Detection helps readers gain the data analytics skills that can bring these anomalies to light. Step-by-step instruction and practical advice provide the specific abilities that will enhance the audit and investigation process. Readers will learn to: Understand the different areas of fraud and their specific detection methods Identify anomalies and risk areas using computerized techniques Develop a step-by-step plan for detecting fraud through data analytics Utilize IDEA software to automate detection and identification procedures The delineation of detection techniques for each type of fraud makes this book a must-have for students and new fraud prevention professionals, and the step-by-step guidance to automation and complex analytics will prove useful for even experienced examiners. With datasets growing exponentially, increasing both the speed and sensitivity of detection helps fraud professionals stay ahead of the game. Fraud and Fraud Detection is a guide to more efficient, more effective fraud identification. |
| fraud case management system: Essentials of Forensic Accounting Michael A. Crain, William S. Hopwood, Carl Pacini, George R. Young, 2018-07-31 The highly experienced authors of the Essentials of Forensic Accounting define and explain the disciplined approaches to forensic accounting that lead to a thorough knowledge of the varied specialties within forensic accounting. Through illustrative examples and explanations, this book makes abstract concepts come to life for both seasoned professionals and students and it will help them understand and navigate successfully in this multifaceted area. The Essentials of Forensic Accounting is an indispensable resource delivering matchless knowledge to practitioners, financial managers and students in understanding the complex elements and factors that impact the forensic accounting practice areas. This vital reference resource focuses the elements that must come together to effectively diminish the incidence and impact of fraudulent activities. The book addresses the main themes of Professional Responsibilities and Practice Management Fundamental Forensic Knowledge, Laws, Courts, and Dispute Resolution Specialized Forensic Knowledge, Bankruptcy, Insolvency, and Reorganization |
| fraud case management system: Executive Roadmap to Fraud Prevention and Internal Control Martin T. Biegelman, Joel T. Bartow, 2012-03-13 Now in a Second Edition, this practical book helps corporate executives and managers how to set up a comprehensive and effective fraud prevention program in any organization. Completely revised with new cases and examples, the book also discusses new global issues around the Foreign Corrupt Practices Act (FCPA). Additionally, it covers best practices for establishing a unit to protect the financial integrity of a business, among other subjects. The book has many checklists and real-world examples to aid in implementation and an instructor's URL including a test bank to aid in course adoptions. |
| fraud case management system: Food Fraud Rosalee S. Hellberg, Karen Everstine, Steven A. Sklare, 2020-11-30 Food Fraud: A Global Threat With Public Health and Economic Consequences serves as a practical resource on the topic of food fraud prevention and compliance with regulatory and industry standards. It includes a brief overview of the history of food fraud, current challenges, and vulnerabilities faced by the food industry, and requirements for compliance with regulatory and industry standards on mitigating vulnerability to food fraud, with a focus on the Global Food Safety Initiative (GFSI) Benchmarking Requirements. The book also provides individual chapters dedicated to specific commodities or sectors of the food industry known to be affected by fraud, with a focus on specific vulnerabilities to fraud, the main types of fraud committed, analytical methods for detection, and strategies for mitigation. The book provides an overview of food fraud mitigation strategies applicable to the food industry and guidance on how to start the process of mitigating the vulnerability to food fraud. The intended audience for this book includes food industry members, food safety and quality assurance practitioners, food science researchers and professors, students, and members of regulatory agencies. - Presents industry and regulatory standards for mitigating vulnerability to food fraud including Global Food Safety Initiative (GFSI) Benchmarking Requirements - Provides tools and resources to comply with industry and regulatory standards, including steps for developing a food fraud vulnerability assessment and mitigation plan - Contains detailed, commodity-specific information on the major targets of food fraud, including specific vulnerabilities to fraud, analytical methods, and strategies for mitigation |
| fraud case management system: The Handbook of Fraud Deterrence Harry Cendrowski, Louis W. Petro, James P. Martin, Adam A. Wadecki, 2007-01-29 The Handbook of Fraud Deterrence encompasses the applicable professional standards and common applications for forensic accounting, fraud deterrence, and fraud investigation services. It is the first book that explains fraud deterrence through internal control improvement within the structure of forensic accounting procedures. |
| fraud case management system: How to be a Successful Frauditor Peter Tickner, 2012-05-22 This book shows how anyone who finds they need to investigate a fraud at work can conduct a successful investigation and maximise their chances of recovering stolen money. Drawing on the experiences of the author, including his role in a number of high profile cases at two organisations at the heart of government, the Treasury and the Metropolitan Police, the book is peppered with real life examples and case studies of the ‘frauditor’s’ experiences, and lessons learned the hard way including the cases of: • The linguist who was lost for words • Doctoring the suits at the hospital • A magician at work • Corporate credit cards for cops Readable, and written to de-bunk the mysteries of fraud investigation, this book includes interactive case studies to develop the reader’s skills in effective fraud detection and investigation. |
| fraud case management system: Tackling Insurance Fraud Lynne Skajaa, Dexter Morse, 2020-11-26 Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud. |
| fraud case management system: Customs Service United States. General Accounting Office, 1992 |
| fraud case management system: State, Foreign Operations, and Related Programs Appropriations for 2015 United States. Congress. House. Committee on Appropriations. Subcommittee on State, Foreign Operations, and Related Programs, 2014 |
| fraud case management system: Expert Fraud Investigation Tracy L. Coenen, 2009-01-23 A fraud investigation is aimed at examining evidence to determine if a fraud occurred, how it happened, who was involved, and how much money was lost. Investigations occur in cases ranging from embezzlement, to falsification of financial statements, to suspicious insurance claims. Expert Fraud Investigation: A Step-by-Step Guide provides all the tools to conduct a fraud investigation, detailing when and how to investigate. This guide takes the professional from the point of opening an investigation, selecting a team, gathering data, and through the entire investigation process. Business executives, auditors, and security professionals will benefit from this book, and companies will find this a useful tool for fighting fraud within their own organizations. |
| fraud case management system: Frauds and Financial Crimes Alan Doig, Michael Levi, 2021-09-16 This edited volume provides a contemporary overview of major issues and control strategies associated with fraud and financial crime, including prevention, public ethics, compliance mechanisms, and law enforcement in England and Wales. The UK – and in particular, England & Wales - has had a number of public strategies and plans to address fraud and financial crime, beginning (in this edited volume) with the 2008 National Fraud Strategy and now including, most recently, the 2020 Local Government Fraud and Corruption strategy, the 2019 Economic Crime Plan and National Fraud Policing Strategy, the 2018 Serious and Organised Crime Strategy, and the 2017 Anti-Corruption Plan. All, together with a number of past, existing, reconfigured and new institutions and procedures, reflect a continuing collective response to emerging issues and themes in fraud and financial crime. Frauds and Financial Crimes: Trends, Strategic Responses and Implementation Issues in England and Wales contributes insights about the continuing interplay of strategic responses, priorities and implementation in an era of budget reductions, competing local and national agendas and a continuing absence of joined-up oversight and ownership. Drawing on both academic and practitioner experts, the book seeks to explore a range of important themes, including: the gaps between strategic intentions and practice on the ground; different approaches to the same issue; labelling of crimes as ‘organised’ and/or ‘economic’; collaborative public-private and inter-agency approaches and problem ownership; the role of prevention; and the translation of experience upwards and policy downwards in development and implementation. In doing so, it seeks to inform more effective strategic responses to fraud and financial crime. The chapters in this book were originally published in the journal Public Money and Management. |
| fraud case management system: Corporate Fraud and Internal Control Workbook Richard E. Cascarino, 2012-12-12 The essential companion to Corporate Fraud and Internal Control, complete with review exercises for key concepts Used together with Corporate Fraud and Internal Control: A Framework for Prevention, this Workbook tests readers' knowledge of the subject with a focus on the appropriateness of the design of the system of internal controls in fraud risk mitigation, as well as the mechanisms to ensure effective implementation and monitoring on an ongoing basis. This Workbook includes step-by-step exercises and tests to help the reader master the techniques in fraud prevention and detection. Companion to Corporate Fraud and Internal Control: A Framework for Prevention Includes step-by-step exercise and tests Provides discussion-based case studies Features the necessary tools that companies need to combat fraud Written by a fraud prevention leader, Corporate Fraud and Internal Control Workbook features a fill in the blanks structure, followed by a short answer section, and ending with a discussion based series of case studies covering the following topics. |
| fraud case management system: Healthcare Fraud Rebecca S. Busch, 2012-05-01 An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the red flags of fraudulent activity within your organization. Eminently readable, it is your go-to resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem. |
| fraud case management system: Encyclopedia of Organizational Knowledge, Administration, and Technology Khosrow-Pour D.B.A., Mehdi, 2020-09-29 For any organization to be successful, it must operate in such a manner that knowledge and information, human resources, and technology are continually taken into consideration and managed effectively. Business concepts are always present regardless of the field or industry – in education, government, healthcare, not-for-profit, engineering, hospitality/tourism, among others. Maintaining organizational awareness and a strategic frame of mind is critical to meeting goals, gaining competitive advantage, and ultimately ensuring sustainability. The Encyclopedia of Organizational Knowledge, Administration, and Technology is an inaugural five-volume publication that offers 193 completely new and previously unpublished articles authored by leading experts on the latest concepts, issues, challenges, innovations, and opportunities covering all aspects of modern organizations. Moreover, it is comprised of content that highlights major breakthroughs, discoveries, and authoritative research results as they pertain to all aspects of organizational growth and development including methodologies that can help companies thrive and analytical tools that assess an organization’s internal health and performance. Insights are offered in key topics such as organizational structure, strategic leadership, information technology management, and business analytics, among others. The knowledge compiled in this publication is designed for entrepreneurs, managers, executives, investors, economic analysts, computer engineers, software programmers, human resource departments, and other industry professionals seeking to understand the latest tools to emerge from this field and who are looking to incorporate them in their practice. Additionally, academicians, researchers, and students in fields that include but are not limited to business, management science, organizational development, entrepreneurship, sociology, corporate psychology, computer science, and information technology will benefit from the research compiled within this publication. |
| fraud case management system: InfoWorld , 1995-12-25 InfoWorld is targeted to Senior IT professionals. Content is segmented into Channels and Topic Centers. InfoWorld also celebrates people, companies, and projects. |
| fraud case management system: Oversight of the Federal Bureau of Investigation United States. Congress. Senate. Committee on the Judiciary, 2011 |
| fraud case management system: Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations for 2000 United States. Congress. House. Committee on Appropriations. Subcommittee on the Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies, 1999 |
| fraud case management system: Visa Fraud and Immigration Benefits Application Fraud United States. Congress. House. Committee on the Judiciary. Subcommittee on Immigration and Claims, 1997 |
| fraud case management system: CSO , 2005-12 The business to business trade publication for information and physical Security professionals. |
| fraud case management system: The transformation of the banking industry: a brave new world SAS Institute, 2011-05-01 As the banking industry enters a period of profound and probably difficult change, not only do the world’s banks face a tidal wave of post-crisis regulatory initiatives and restructuring, they also face a widespread loss of public confidence. However, new pressures bring new ideas and new opportunities. The transformation of the banking industry: a brave new world is a collection of visionary articles from senior executives illustrating what lies ahead for the banking industry and how that industry is transforming in light of the effects of the global financial crisis. Banks need to understand their customers, their markets, and their risk exposures more than ever. The transformation of the banking industry is a must-read for anyone in the banking industry! |
| fraud case management system: Handbook of Massive Data Sets James Abello, Panos M. Pardalos, Mauricio G.C. Resende, 2013-12-21 The proliferation of massive data sets brings with it a series of special computational challenges. This data avalanche arises in a wide range of scientific and commercial applications. With advances in computer and information technologies, many of these challenges are beginning to be addressed by diverse inter-disciplinary groups, that indude computer scientists, mathematicians, statisticians and engineers, working in dose cooperation with application domain experts. High profile applications indude astrophysics, bio-technology, demographics, finance, geographi cal information systems, government, medicine, telecommunications, the environment and the internet. John R. Tucker of the Board on Mathe matical Seiences has stated: My interest in this problern (Massive Data Sets) isthat I see it as the rnost irnportant cross-cutting problern for the rnathernatical sciences in practical problern solving for the next decade, because it is so pervasive. The Handbook of Massive Data Sets is comprised of articles writ ten by experts on selected topics that deal with some major aspect of massive data sets. It contains chapters on information retrieval both in the internet and in the traditional sense, web crawlers, massive graphs, string processing, data compression, dustering methods, wavelets, op timization, external memory algorithms and data structures, the US national duster project, high performance computing, data warehouses, data cubes, semi-structured data, data squashing, data quality, billing in the large, fraud detection, and data processing in astrophysics, air pollution, biomolecular data, earth observation and the environment. |
| fraud case management system: Knowledge Management Irma Becerra-Fernandez, Rajiv Sabherwal, Richard Kumi, 2024-02-23 Knowledge Management: Systems and Processes in the AI Era, Third Edition, is aimed at students and managers who seek detailed insights into contemporary knowledge management (KM). It explains the concepts, theories, and technologies that provide the foundation for knowledge management; the systems and structures that constitute KM solutions; and the processes for developing, deploying, and evaluating these KM solutions. This book serves as a complete introduction to the subject of knowledge management, incorporating technical and social aspects, as well as concepts, practical examples, traditional KM approaches, and emerging topics. This third edition has been revised and expanded to include more coverage of emergent trends such as cloud computing, online communities, crowdsourcing, and artificial intelligence. Aimed at advanced undergraduate, postgraduate, and MBA students who are seeking a comprehensive perspective on knowledge management, Knowledge Management is also complemented by online support for lecturers including suggested solutions to the many review questions and application exercises contained within the book. |
| fraud case management system: Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations for 2000: Justification of the budget estimates, Department of Justice United States. Congress. House. Committee on Appropriations. Subcommittee on the Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies, 1999 |
| fraud case management system: Internal Control and Fraud Detection Jae K. Shim, 2011 This book also covers Management's Antifraud Programs and Controls and the risk factors included in SAS No. 99. A major section then deals with forensic accounting. -- |
Fraud: Definition, Types, and Consequences of Fraudulent Behavior
Apr 30, 2025 · Fraud is an intentional act of deceit designed to reward the perpetrator or to deny the rights of a victim. Some of the most common types of fraud involve the insurance industry, …
Fraud - Wikipedia
In law, fraud is intentional deception to deprive a victim of a legal right or to gain from a victim unlawfully or unfairly.
FRAUD Definition & Meaning - Merriam-Webster
The meaning of FRAUD is deceit, trickery; specifically : intentional perversion of truth in order to induce another to part with something of value or to surrender a legal right.
Fraud 101: What Is Fraud? - Association of Certified Fraud …
“Fraud” is any activity that relies on deception in order to achieve a gain. Fraud becomes a crime when it is a “knowing misrepresentation of the truth or concealment of a material fact to induce …
Fraud - Definition, Meaning, Types, and Examples - Legal Dictionary
Dec 1, 2014 · Fraud takes place when a person deliberately practices deception in order to gain something unlawfully or unfairly. In most states, the act of fraud can be classified as either a …
fraud | Wex | US Law | LII / Legal Information Institute
Fraud is both a civil tort and criminal wrong. In civil litigation , allegations of fraud might be based on a misrepresentation of fact that was either intentional or negligent .
Fraud - Office for Victims of Crime
Discover publications, resources, and other information about victims of fraud.
Fraud - FindLaw
Nov 23, 2023 · Fraud can take many forms. One commits fraud through false statements, misrepresentation, or dishonest conduct intended to mislead or deceive. This article looks at …
What Is Fraud? Types And Definitions - Financial Crime Academy
Jun 10, 2025 · Fraud is defined as an intentionally deceptive action intended to provide the perpetrator with an unlawful gain or to deny a victim’s right. Tax fraud, credit card fraud, wire …
Fraud | Types of Fraud Crimes & Their Penalties
3 days ago · The broad legal definition of fraud is the intentional deception of another for personal gain. A person who defrauds another deprives the victim of his or her money or property for …
Next Generation Healthcare Fraud Management - CGI.com
In the case of true fraud, the likelihood of recovery diminishes over time. 1. 2 The preferred method of addressing FWA is pre-pay identification and ... Having a common rules engine, …
Item 4.1 - Appendix Counter Fraud Investigations Update …
Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case Management system a …
financial-crime-risk-management-platform-fact-sheet
Unified case management for AML and fraud Better performance on internal and external examinations Connect With Us Fiserv, Inc. 255 Fiserv Drive Brookfield, WI 53045 800-872 …
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Unified Financial Crime Case Management System A single, integrated AML-Fraud case management system provides a modernized user experience by displaying visual relationships …
OSCAR VALDEZ ASSISTANT AUDITOR-CONTROLLERS …
Nov 22, 2023 · the Department’s case management system by reviewing the Operations Memo distributed to managers and staff reminding them of the procedures for processing early fraud …
Item 4.1 Counter Fraud Investigations Update Report
Jun 23, 2022 · Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case …
Item 7.7 Appendix 2 Summary - ctmuhb.nhs.wales
Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case Management system a …
Swansea Bay University Health Board Counter Fraud Work …
NHS Fraud Case Management System. Inform & Involve NHSCFA Standard Functional Standard Notes 2.1 Ongoing programme of fraud awareness Component 11 NHS Requirement 11 2.2 …
Item 8.3 Appendix 1 Summary
Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case Management system a …
Investigating and Combating Health Insurance Fraud
The Department’s web-based case management system, known as the Fraud Case Management System (“FCMS”), allows insurers to submit reports of suspected fraud electronically. In 2019, …
Pega Smart Dispute for Issuers Product Overview
Fraud processing Pega Smart Dispute for Issuers parent/child case management is critical for processing fraud claims, where typically more than one transaction is affected. This …
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Outseer Fraud Manager
Outseer case management Our case management application enables you to track activities that trigger rules and determine if they are fraudulent. You can also use the application to research …
Investigating and Combating Health Insurance Fraud
The High Cost of Healthcare Fraud Healthcare fraud is a costly and pervasive drain on the national healthcare system. Experts agree that the costs of healthcare fraud are exorbitant; the …
Item 4.1 - Appendix Counter Fraud Investigations Update …
Aug 22, 2022 · Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case …
Item 4.1 Appendix 3 Counter Fraud Investigations Update …
Dec 12, 2022 · Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case …
June 2023 Status Update for Wyoming MMIS WINGS Project …
Jun 8, 2023 · Care/Case Management System 2 (CCMS-2) Module – The CCMS-2 project is in the pre-planning stages. An RFP release is being tentatively planned for Summer 2023. ...
Banking use case: Detecting online and mobile fraud with AI
to a bank system managing fraud cases. Adding in Microsoft’s Dynamics 365 CRM for fraud case management solution can provide a sophisticat-ed 360 closed loop fraud management …
September 2012 BORDER SECURITY - U.S. Government …
the five FPMs with whom GAO spoke had not been trained in State's new fraud case management system. Visa Applicants at a High Fraud Post Wait for Interviews with Consular …
Analysis: Internal Controls Impact on the Mitigation of Risk …
Analysis: Internal Controls Impact on the Mitigation of Risk & Fraud in Public Finance – Brian Stephens . 6 . managed. The organization considers the potential for fraud in accessing the …
Item 5.3 Appendix Summary - ctmuhb.nhs.wales
Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case Management system a …
RBI’s Master Direction on Fraud Risk Management in Banks
• Reporting of each individual fraud case promptly, within 14 days from its classification, regardless of the amount ... Senior management (anti-fraud function within risk) Lines of …
Digital fraud: The case for change - deloitte.com
points, fraud risks, and existing fraud mitigation capabilities. 11 • Fraud risk assessment: Conducting a comprehensive fraud risk assessment helps in identifying vulnerabilities and …
Case Analytics Workbench - Capgemini
a unified platform to streamline case tracking, automate repetitive tasks, and significantly improve collaboration. At the heart of our solution is a centralized . analytics workbench that eliminates …
Effectiveness of internal control on detection and prevention …
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Investigating and Combating Health Insurance Fraud
Mar 15, 2021 · The Department’s web-based case management system, known as the Fraud Case Management System (“FCMS”), allows insurers to submit reports of suspected fraud …
INTERNAL CONTROL SYSTEM AND FRAUD RISK …
control system and fraud risk management of rural and banks. The first set is a questionnaire is for the independent variable. Part I dealt with the personal profile of the respondents along …
The Moderating role of Internal Control on the Relationship …
Accounting Information System and Detection of Fraud: The Case of the Jordanian Banks. International Journal of Academic Research in Economics and Management Sciences , 8 (1), …
EFFECTIVELY STRUCTURING A STRONG FRAUD, WASTE, AND …
FRAUD, WASTE, AND ABUSE PROGRAM William Gedman CPA, CIA Vice President Quality Audit, Fraud & Abuse UPMC Health Plan – Pittsburgh, PA ... (Database or case management …
Brochure Worldline Fraud Management.
mitigate fraud, ensuring a secure banking environment. Whitelisting: Banks can bypass blocking rules for trusted account numbers, enabling smooth and uninterrupted legitimate transactions. …
1. Solicitation Number Page of Pages AWARD/CONTRACT
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• to encourage uniformity on case flow management at lower court level. • to introduce training and research on case flow management draft. These guidelines have been developed as an …
Investigating and Combating Health Insurance Fraud
Mar 15, 2021 · The Department’s web-based case management system, known as the Fraud Case Management System (“FCMS”), allows insurers to submit reports of suspected fraud …
Actimize Essentials: Sophisticated AML-Fraud Integrated on …
AML-Fraud case management system. A modernized user experience displays visual relationships across entities to quickly identify connections and reveal deep insights. This …
Fraud Case Management v14
entity, the Blackthorn Fraud Case Management system provides a framework for ensuring that investigations follow a considered and optimised plan, evidence is carefully organised and …
The Impact of China’s Independent Director System on …
This paper will use case analysis as the research method, Kangmei Pharmaceutical fraud case as the research object. The fraud case of Kangmei Pharmaceutical is the most serious financial …
Item 4.1 - Appendix Counter Fraud Investigations Update …
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FRAUD CONTROL UNIT SFY 2023 ACCOMPLISHMENTS
Referrals Made to the Fraud Control Unit Fraud case referrals often involve benefits received from one or more programs. Most commonly, these ... Claims collection data in this report are …
FRAUD CONTROL FRAMEWORKS - uaeaa.gov.ae
A fraud control framework is a system of co-ordinated measures put in place by organisations to prevent, detect and respond to any instances of fraud. ... For day to day management of the …
NefSearch - Nepal Economic Forum
Financial Statement Fraud is the least common type of fraud occurring least frequently and in only 10% of all fraud cases worldwide. However it is the most expensive as it leads to huge losses …
Investigating and Combating Health Insurance Fraud
insurance fraud to DFS. DFS has a web-based case management system, known as the Fraud Case Management System (“FCMS”), which allows insurers to submit reports of suspected …
1. Solicitation Number Page of Pages AWARD/CONTRACT
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2024 ANNUAL REPORT
telephone fraud hotline, DOI email fraud hotline, and U.S. mail that were anonymous and /or did not have sufficient information to meet the filing requirements to create a case file in the …
Item 6.4 Appendix 2 Summary
Counter Fraud Case Management system only for the purposes of recording these outcomes for intelligence purposes. As cases are closed on the Counter Fraud Case Management system a …
Does Forensic Accounting Matter? Diagnosing Fraud Using …
internal control system will be an effective tool to control fraud risk. Internal controls can be fully effective if the organization is able to understand the most vulnerable risks and how to respond …
EFFECTIVELY STRUCTURING A STRONG FRAUD, WASTE, AND …
FRAUD, WASTE, AND ABUSE PROGRAM William Gedman CPA, CIA Vice President Quality Audit, Fraud & Abuse UPMC Health Plan – Pittsburgh, PA ... (Database or case management …
Minnesota Department of Human Services
Fraud Control expenditures are costs associated with the investigation and/or prosecution of welfare fraud and can be claimed by any county in section Cof the DHS-2550. Fraud Control …
