Nikhil Sudepalli

Result-driven Fraud Investigation & Compliance Analyst with a versatile background spanning Financial Crimes, Transaction Monitoring, and Healthcare Claims Risk management. Proven expertise in conducting end-to-end transaction monitoring, executing global sanction screening (OFAC, PEP, World-Check), performing Enhanced Due Diligence (EDD), and auditing high-volume medical claims for Fraud, Waste, and Abuse (FWA). Highly skilled in leveraging advanced analytical systems like LexisNexis, Actimize, Excel, and Power BI to synthesize investigative data, draft definitive regulatory filings (SAR/STR), and safeguard organizational assets from fraudulent activities.

Fraud & AML Compliance Analyst - INTOUCHCX - Hyderabad

(2025-04 - 2026-06)

• Conducted end-to-end Transaction Monitoring and risk investigations on customer and merchant accounts to mitigate Financial Crimes and fraud prevention risks.
• Executed complete Sanction Screening workflows against global watchlists, managing OFAC, Politically Exposed Persons (PEP), and World-Check matches to track and stop illicit activities.
• Performed deep-dive Enhanced Due Diligence (EDD) and comprehensive Due Diligence Reviews on high-risk accounts demonstrating suspicious fund movements or location anomalies.
• Drafted thorough internal investigative documentation to support the preparation of Suspicious Activity Reports (SAR) and Suspicious Transaction Reports (STR) in compliance with policy metrics.
• Leveraged advanced analytical tools and risk infrastructure (LexisNexis, Actimize components, Microsoft Excel) to resolve alert backlogs, track Rapid Fund variations, and process Request for Information (RFI) files.

Fraud & Claims Analyst (Healthcare Risk) - Global Software - Chennai

(2024-06 - 2025-03)

• Audited and analyzed high-volume medical claims to identify patterns of Fraud, Waste, and Abuse (FWA), including upcoding, unbundling, and phantom billing.
• Verified provider and insurance eligibility through data-driven investigations, flagging and resolving high-risk or suspicious billing discrepancies.
• Utilized data analysis tools to perform variance analysis on claim trends, detecting anomalous billing patterns before financial payout.
• Investigated and resolved complex billing appeals, compiling evidence-based risk reports to safeguard funds from potentially fraudulent payouts.
• Ensured absolute compliance with stringent healthcare regulatory guidelines and privacy mandates, protecting sensitive customer data during investigations.

B.Tech - Biotechnology - KL University (2024-04)