Fraud Prevention Oriented Data Mining

One of the most useful components of our Chapter’s recently completed two-day seminar on Cyber Fraud & Data Breaches was our speaker, Cary Moore’s, observations on the fraud fighting potential of management’s creative use of data mining. For CFEs and forensic accountants, the benefits of data mining go much deeper than as just a tool to help our clients combat traditional fraud, waste and abuse. In its simplest form, data mining provides automated, continuous feedback to ensure that systems and anti-fraud related internal controls operate as intended and that transactions are processed in accordance with policies, laws and regulations. It can also provide our client managements with timely information that can permit a shift from traditional retrospective/detective activities to the proactive/preventive activities so important to today’s concept of what effective fraud prevention should be. Data mining can put the organization out front of potential fraud vulnerability problems, giving it an opportunity to act to avoid or mitigate the impact of negative events or financial irregularities.

Data mining tests can produce “red flags” that help identify the root cause of problems and allow actionable enhancements to systems, processes and internal controls that address systemic weaknesses. Applied appropriately, data mining tools enable organizations to realize important benefits, such as cost optimization, adoption of less costly business models, improved program, contract and payment management, and process hardening for fraud prevention.

In its most complex, modern form, data mining can be used to:

–Inform decision-making
–Provide predictive intelligence and trend analysis
–Support mission performance
–Improve governance capabilities, especially dynamic risk assessment
–Enhance oversight and transparency by targeting areas of highest value or fraud risk for increased scrutiny
–Reduce costs especially for areas that represent lower risk of irregularities
–Improve operating performance

Cary emphasized that leading, successful organizational implementers have tended to take a measured approach initially when embarking on a fraud prevention-oriented data mining initiative, starting small and focusing on particular “pain points” or areas of opportunity to tackle first, such as whether only eligible recipients are receiving program funds or targeting business processes that have previously experienced actual frauds. Through this approach, organizations can deliver quick wins to demonstrate an early return on investment and then build upon that success as they move to more sophisticated data mining applications.

So, according to ACFE guidance, what are the ingredients of a successful data mining program oriented toward fraud prevention? There are several steps, which should be helpful to any organization in setting up such an effort with fraud, waste, abuse identification/prevention in mind:

–Avoid problems by adopting commonly used data mining approaches and related tools.

This is essentially a cultural transformation for any organization that has either not understood the value these tools can bring or has viewed their implementation as someone else’s responsibility. Given the cyber fraud and breach related challenges faced by all types of organizations today, it should be easier for fraud examiners and forensic accountants to convince management of the need to use these tools to prevent problems and to improve the ability to focus on cost-effective means of better controlling fraud -related vulnerabilities.

–Understand the potential that data mining provides to the organization to support day to day management of fraud risk and strategic fraud prevention.

Understanding, both the value of data mining and how to use the results, is at the heart of effectively leveraging these tools. The CEO and corporate counsel can play an important educational and support role for a program that must ultimately be owned by line managers who have responsibility for their own programs and operations.

–Adopt a version of an enterprise risk management program (ERM) that includes a consideration of fraud risk.

An organization must thoroughly understand its risks and establish a risk appetite across the enterprise. In this way, it can focus on those area of highest value to the organization. An organization should take stock of its risks and ask itself fundamental questions, such as:

-What do we lose sleep over?
-What do we not want to hear about us on the evening news or read about in the print media or on a blog?
-What do we want to make sure happens and happens well?

Data mining can be an integral part of an overall program for enterprise risk management. Both are premised on establishing a risk appetite and incorporating a governance and reporting framework. This framework in turn helps ensure that day-to-day decisions are made in line with the risk appetite, and are supported by data needed to monitor, manage and alleviate risk to an acceptable level. The monitoring capabilities of data mining are fundamental to managing risk and focusing on issues of importance to the organization. The application of ERM concepts can provide a framework within which to anchor a fraud prevention program supported by effective data mining.

–Determine how your client is going to use the data mined information in managing the enterprise and safeguarding enterprise assets from fraud, waste and abuse.

Once an organization is on top of the data, using it effectively becomes paramount and should be considered as the information requirements are being developed. As Cary pointed out, getting the right data has been cited as being the top challenge by 20 percent of ACFE surveyed respondents, whereas 40 percent said the top challenge was the “lack of understanding of how to use analytics”. Developing a shared understanding so that everyone is on the same page is critical to success.

–Keep building and enhancing the application of data mining tools.

As indicated above, a tried and true approach is to begin with the lower hanging fruit, something that will get your client started and will provide an opportunity to learn on a smaller scale. The experience gained will help enable the expansion and the enhancement of data mining tools. While this may be done gradually, it should be a priority and not viewed as the “management reform initiative of the day. There should be a clear game plan for building data mining capabilities into the fiber of management’s fraud and breach prevention effort.

–Use data mining as a tool for accountability and compliance with the fraud prevention program.

It is important to hold managers accountable for not only helping institute robust data mining programs, but for the results of these programs. Has the client developed performance measures that clearly demonstrate the results of using these tools? Do they reward those managers who are in the forefront in implementing these tools? Do they make it clear to those who don’t that their resistance or hesitation are not acceptable?

–View this as a continuous process and not a “one and done” exercise.

Risks change over time. Fraudsters are always adjusting their targets and moving to exploit new and emerging weaknesses. They follow the money. Technology will continue to evolve, and it will both introduce new risks but also new opportunities and tools for management. This client management effort to protect against dangers and rectify errors is one that never ends, but also one that can pay benefits in preventing or managing cyber-attacks and breaches that far outweigh the costs if effectively and efficiently implemented.

In conclusion, the stark realities of today’s cyber related challenges at all levels of business, private and public, and the need to address ever rising service delivery expectations have raised the stakes for managing the cost of doing business and conducting the on-going war against fraud, waste and abuse. Today’s client-managers should want to be on top of problems before they become significant, and the strategic use of data mining tools can help them manage and protect their enterprises whilst saving money…a win/win opportunity for the client and for the CFE.

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