Senior Special Investigator
New
S
SageSureProperty Insurance
RemoteFull-TimeSenior
Salary not disclosed
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Job Details
- Experience
- 10 years experience conducting fraud investigations
- Required Skills
- Data AnalysisStakeholder management
Requirements
- Bachelor's degree in a related field or equivalent relevant education.
- 10 years of experience conducting fraud investigations.
- Minimum 7 years of comprehensive experience in P&C SIU/Fraud investigations OR 9 years in a related fraud industry role.
- Exceptional expertise in fraud investigations, case law, and state regulations.
- Proven track record in conducting complex statements involving multiple parties.
- Proficiency in gathering evidence and performing objective data analysis.
- Ability to organize and prioritize workloads and handle multiple complex tasks.
- Proficiency in using computers and software for data input and analysis.
- Knowledge of legal principles, contract law, medical treatment, and medical terminology.
- Demonstrated expertise in managing specialty, complex, or litigated claims.
Responsibilities
- Lead the development and execution of comprehensive fraud prevention strategies and investigative operations.
- Review fraud referrals to determine red flags and assign work to investigators.
- Conduct high-profile and sensitive special investigations involving intricate fraud referrals.
- Apply advanced knowledge of state laws and P&C insurance regulations to investigative work.
- Prepare and deliver detailed verbal and written investigative reports.
- Serve as a subject matter expert and provide training for SIU and claims/underwriting personnel.
- Cultivate and sustain relationships with industry stakeholders and law enforcement.
- Perform CAT duty responsibilities as required.
- Support regulatory compliance activities including research and reporting.
- Manage and present findings on fraud trends to leadership.
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