Special Claims Desk Investigator

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Requirements:

• Education: Bachelor’s Degree or equivalent experience.
• Field of Study: Law Enforcement, Criminal Justice, Liberal Arts, Business, Computer Science or a related discipline.
• Experience: 3 to 6 years of related experience, including Criminal Investigation or Fraud Detection experience.
• Professional designation (e.g., Certified Fraud Examiner, Private Investigator license) preferred.

Responsibilities:

• Conducts specific investigations for claims cases.
• Investigates all suspect fraud referrals.
• Secures necessary information (i.e., reports, policies, appraisals, releases, statements, or other documents) to assist in the investigation of claims.
• Identifies trends and patterns of suspected fraudulent activity.
• Handles field investigations or assigns field work to independent investigation firms.
• Coordinates efforts with law enforcement agencies, state agencies, Claims personnel, and counsel.
• Prepares comprehensive investigation reports.
• Evaluates claims and recommends courses of action to management.
• May provide evidence and/or testify in prosecution cases.
• Assists in developing awareness or training on fraud detection and prevention.
• May provide guidance to less experienced staff.