arXiv Machine Learning By Yubin Park, Evan Brociner

From Prediction to Explainable Provider Behavior Profiles for Fraud, Waste, and Abuse Review

Read the original on arXiv Machine Learning →

The paper proposes a shift from predictive modeling to descriptive provider behavior profiles for fraud, waste, and abuse (FWA) review. By decomposing billed revenue into provider scale and procedure composition, the authors construct lineage‑aware profiles that capture scale history, code lineage, and clinical family shares. In a large Medicare audit, these simple, interpretable descriptions outperform complex forecasts and improve recall for high‑cost rare events, while an optional semantic factorization adds context without inferring intent.

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arXiv AI
Jul 21

Detection, Attribution, Narration: An End-to-End Pipeline for Explainable Money Mule Identification

arXiv:2607. 17586v1 Announce Type: cross Abstract: Money mule accounts are critical facilitators of financial fraud, yet detecting them at scale remains challenging due to the heterogeneous nature of transactional and behavioural data.

By Yuge Zhang, Yuanxing Zhang, Yichao Jin, Khairul Amsyar Mohd Razis, Nicholas Qi An Choo, Kai Yin Anders Wong, Xinyan Tang, Kenneth Zhu Ke, Wee Keong Dennis Lee, Jingyuan Zhao
arXiv AI
Aug 19

Explicit State Elicitation Is Not Enough: A Controlled Audit of Memory-Policy Classification

The paper investigates how personalized agents decide to use, ignore, update, or query retrieved user memory before acting on a task. An empirical audit protocol is developed to test structured intermediate outputs, revealing that while exposing state definitions improves accuracy, an explicit state-output field does not significantly enhance policy accuracy for large language models. The study also shows that example-level accuracy overstates consistency, with full four‑way family success being rare, and that providing benchmark‑associated state labels merely conditions predictions rather than proving internal fidelity.

By Yihang Chen, Pin Qian, Su Wang, Chong Peng, Huan Xu, Shuaiting Li, Yiqi Sun
arXiv Machine Learning
Sep 25

MemGuard-Alpha: Limits of Membership Inference for Detecting and Filtering Memorization-Contaminated Signals in LLM-Based Financial Forecasting

MemGuard-Alpha evaluates whether membership inference attacks (MIA) can detect memorization in large language models (LLMs) used for financial alpha signals. The study combines five MIA methods with a temporal proximity feature and a cross-model disagreement metric, then audits them across seven LLMs, 50 S&P 100 stocks, and 299,600 prompt-model pairs. Findings show that temporal proximity alone perfectly predicts in-sample status, MIA discriminative power largely stems from model scale differences, and filtering based on contamination scores does not improve risk-adjusted performance once transaction costs are considered.

By Anisha Roy, Dip Roy
arXiv AI
Aug 28

Explainable Artificial Intelligence for Customer Churn Prediction in Telecommunications: A Framework for CRM Integration

The paper presents a framework for integrating explainable AI into customer churn prediction for telecommunications. It benchmarks four classifiers—Logistic Regression, Random Forest, XGBoost, and LightGBM—on the IBM Telco Customer Churn dataset, finding comparable performance with Logistic Regression achieving the highest AUC-ROC and LightGBM the highest accuracy. Explanations are provided via SHAP and LIME at both global and instance levels, and a four‑layer CRM integration architecture is proposed to translate risk scores and attribution vectors into actionable retention strategies, projecting a 3.3–5.3 percentage point reduction in churn and $199K–$319K savings per campaign cycle.

By Sandeep Gaddamwar