Fraud Investigator duties and responsibilities
- Conducting investigations into allegations of fraud, waste or abuse committed by clients against our company
- Reviewing and researching evidence/documents to analyze the overall fact pattern of claim and synthesize data into a professional report with recommendations
- Preparing and coordinating field assignments to obtain relevant evidence and information
Fraud Investigator Job Description Template
Job Brief
We are looking for a talented Fraud Investigator to be responsible for identifying and handling suspicious or problematic insurance claims while providing consultation and strategic directions through professional reports.
The ideal candidate should have demonstrable analytical skills along with a passion for research and investigative evidence analysis.
Responsibilities
- Conduct objective, fair, thorough, unbiased and timely investigations into allegations of fraud, waste or abuse committed by clients against our company
- Review and research evidence/documents to analyze the overall fact pattern of claim and synthesize data into a professional report with recommendations
- Prepare and coordinate field assignments to obtain relevant evidence and information
- Coordinate with defense attorneys to provide deposition strategies and use law enforcement resources for assistance
- Manage and prioritize a large and varied case load effectively and efficiently to achieve positive results
- Prepare prosecution packages and restitution proposals
Requirements
- Proven working experience in related field
- Strong interpersonal and communication skills including the ability to interact with clients, upper management and law enforcement
- Ingenuity and persistence to obtain case information not readily available with an eye for detail
- Ability to work independently with minimum supervision
- Good organisational skills needed to manage a high volume of assigned cases
- Proficient with the insurance procedures, regulations and investigation methods
- Hands on experience with relevant Information System
- Display good interviewing and interrogation skills along with the capability of drafting reports
- Honest and ethical with high levels of integrity and confidentiality
- Willing to submit to extensive background checks and provide employment recommendations
- BS degree in a related field (e.g. insurance studies, criminal justice, risk management) or other relevant certification preferred (e.g. Certificate of Insurance Fraud Investigator)
Jobs similar to Fraud Investigator
Fraud Investigator Job Description Examples
Fraud Investigator: Upper East Tennessee
The Tennessee Comptroller of the Treasury is seeking an Investigator to investigate allegations of fraud, waste, and abuse in government and publicly funded entities, primarily in Knoxville, Johnson City, and the Tri-Cities area...
This will involve:• Applying accounting principles and techniques to analyze data from large books and records (manual an...
Purpose of JobAbout USAA...USAA knows what it means to serve. We facilitate the financial security of millions of U.S. military members and their families. This singular missionrequires a dedication to innovative thinking at every level.
Conducts internal or external fraud investigations and files regulatory reports according to legal requirements while ensuring adherence to all applicable...
About Working at Commerce
Wouldn’t it be great to build your career at a bank that’s known for helping people with their financial challenges? That’s exactly what you’d be doing when you join the team at Commerce Bank. We’re looking for teammates who are ready to do whatever it takes to help our customers with their everyday financial needs. You’d be helping yourself too, because Commerce has ...
The Fraud Investigator is responsible for applying fact-finding methods to investigate potential fraudulent activity, including the evaluation of transactions in Cable, Internet and Mobile Orders.
The ideal candidate will seek to achieve the optimal balance between customer experience and fraud prevention through interaction with callers, and maintain that balance as the business grows and fra...
on Linkedin
Gather verified email addresses & phone numbers directly from LinkedIn, reach out, and see when candidates open your emails.
Get Started Free