Claims Special Investigator III
Claims Special Investigator III
Job Summary
This position's primary responsibility is the investigation and disposition of potentially fraudulent claims in any product line sold by the organization. The position also acts as liaison between the organization and industry entities, which include other carriers, law enforcement, District Attorneys, NICB and the Department of Insurance. The position requires a diverse skill set which includes investigating, public speaking, teaching and reporting.
Job Duties
• Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims. Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, and background searches and research as appropriate.
• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings and recommendations to claims staff.
• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.
• Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.
• Provide training to claims staff on insurance fraud and industry trends. Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.
• The position requires a higher degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.
Qualifications
• Bachelors Equivalent combination of education and experience Preferred
• 4-6 years 4-6 Year prior Claims experience Required
• Moderate computer and line of business technical software skills required.
• Advanced application of policy language as applied to coverage, liability, and settlement
• Advanced organization and planning recognition skills required.
• Advanced oral and written communication skills required.
• Advanced interpersonal skills required.
• Advanced interviewing and negotiation skills required.
• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
Travel Requirements
Claims field duties may involve driving and local travel to canvas scenes and interview witnesses.
The starting pay range for this position is:
$35.94 - $47.87
Additionally, for full time positions, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plans with company match AND Pension
• Tuition assistance
• Floating holidays and PTO for community volunteer programs
• Paid parental leave
• Wellness programs
• Employee discounts (membership, insurance,
travel, entertainment, services and more!)
Apply tot his job
Apply To this Job
Job Summary
This position's primary responsibility is the investigation and disposition of potentially fraudulent claims in any product line sold by the organization. The position also acts as liaison between the organization and industry entities, which include other carriers, law enforcement, District Attorneys, NICB and the Department of Insurance. The position requires a diverse skill set which includes investigating, public speaking, teaching and reporting.
Job Duties
• Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims. Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, and background searches and research as appropriate.
• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings and recommendations to claims staff.
• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.
• Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.
• Provide training to claims staff on insurance fraud and industry trends. Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.
• The position requires a higher degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.
Qualifications
• Bachelors Equivalent combination of education and experience Preferred
• 4-6 years 4-6 Year prior Claims experience Required
• Moderate computer and line of business technical software skills required.
• Advanced application of policy language as applied to coverage, liability, and settlement
• Advanced organization and planning recognition skills required.
• Advanced oral and written communication skills required.
• Advanced interpersonal skills required.
• Advanced interviewing and negotiation skills required.
• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
Travel Requirements
Claims field duties may involve driving and local travel to canvas scenes and interview witnesses.
The starting pay range for this position is:
$35.94 - $47.87
Additionally, for full time positions, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plans with company match AND Pension
• Tuition assistance
• Floating holidays and PTO for community volunteer programs
• Paid parental leave
• Wellness programs
• Employee discounts (membership, insurance,
travel, entertainment, services and more!)
Apply tot his job
Apply To this Job