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Certified Fraud Examiner (CFE)

What does CFE stand for in healthcare compliance?

The abbreviation CFE refers to Certified Fraud Examiner, a specialist in fraudulent behaviors. 

 

What is a Certified Fraud Examiner (CFE)?

According to the Association of Certified Fraud Examiners, a certified fraud examiner is essentially a combination of accountant, attorney, criminologist, and investigator. Certified fraud examiners work in a number of industries such as the government, financial, and service industries. 

As a certified fraud examiner, there are several available careers. Such careers include:

    1. Forensic accountant
    2. Financial analyst
    3. Director of loss prevention
    4. Security consultant
    5. Special agent
    6. Law enforcement
    7. Risk manager
    8. Compliance officer
    9. External auditor
    10. Internal auditor
    11. Inspector general
    12. Audit consultant
    13. State investigator
    14. Private investigator

 

What does a Certified Fraud Examiner (CFE) do?

Because the job of a certified fraud examiner is so essential, they must receive professional training. To become a certified fraud examiner, a person must go through the following steps:

    1. Earn a bachelor’s degree
    2. Gain two years of experience in a field that is related to fraud detection or prevention
    3. Join the Association of Certified Fraud Examiners
    4. Apply and prepare for the Certified Fraud Examiner exam
    5. Pass the Certified Fraud Examiner exam

A certain amount of points are awarded to certified fraud examiner applicants based on their education and work experiences. As far as education goes, there is no need for any specific degree. However, the Association of Fraud Examiners Board requires that work experiences fall into any of the following categories:

    • Accounting
    • Auditing
    • Criminology
    • Fraud investigation
    • Law
    • Loss prevention
    • Sociology

Applicants need 50 points to be considered – in addition to a passing grade on the Certified Fraud Examiner exam. The Certified Fraud Examiner exam covers four main topics: law, fraud investigation methods, fraud transactions and fraud schemes, and fraud prevention and deterrence. These four focus areas must be well understood since they are necessary to perform the job. 

A certified fraud examiner is responsible for recognizing fraudulent warning signs, digging up evidence regarding fraudulent transactions, and training others to perform the latter tasks. There are many skills that certified fraud examiners must have. Some of these skills include:

    • Understanding why fraud is committed
    • Understanding how fraud is committed 
    • Finding ways to identify fraudulent behaviors 
    • Interviewing witnesses to gain information 
    • Interviewing suspects to gain a confession or information
    • Reviewing records
    • Performing background checks
    • Writing reports
    • Presenting information found during an investigation
    • Testifying in court 

Because certified fraud examiners have an incredibly diverse skill set, they are practical for various organizations. For example, certified fraud examiners are an excellent resource for the healthcare industry since they can investigate, identify, and prevent fraudulent behavior within healthcare organizations. 

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