Insurance Fraud Investigator

Placements24; Kimberley; Hybrid; CAD 60,000 - 90,000; Full time

Benefits offered by this job

Hybrid work model

Performance-based incentives

Health, dental, and vision insurance

Retirement savings plan

Fraud investigation training

Job summary

Placements24 is seeking an Insurance Fraud Investigator for a hybrid role that blends remote investigative work with on-site duties as required. You will detect, investigate, and prevent fraudulent insurance claims across various lines of business, applying keen attention to detail and strong analytical skills.

Responsibilities include gathering evidence, interviewing claimants and witnesses, preparing comprehensive reports, and collaborating with legal counsel, law enforcement, and internal

Qualifications

• Proven experience as a Fraud Investigator, preferably in insurance.
• Strong understanding of insurance policies and claims processes.
• Excellent investigative, analytical, and critical thinking skills.
• Superior interviewing and interrogation techniques.
• Proficiency with databases and investigative tools.

Responsibilities

• Investigate suspicious insurance claims to determine fraud validity.
• Gather and analyze evidence including financial records and statements.
• Conduct interviews with claimants, witnesses, and other involved parties.
• Prepare detailed investigation reports with findings and recommendations.
• Collaborate with legal counsel, law enforcement, and external agencies as needed.
• Develop fraud prevention strategies and educate internal teams.

Skills

Fraud investigation

Analytical thinking

Interviewing skills

Interrogation techniques

Database tools

Tools

Investigation databases

Evidence gathering tools

Job description

About the Role

Our client is seeking a vigilant and resourceful Insurance Fraud Investigator to join their team. This hybrid role combines remote investigative work with potential on-site duties as required. You will be responsible for detecting, investigating, and preventing fraudulent insurance claims across various lines of business. Your keen eye for detail and strong analytical skills will be crucial in uncovering fraudulent activities and protecting the company's assets. This position demands integrity, discretion, and a proactive approach to combating insurance fraud.

Key Responsibilities

• Investigate suspicious insurance claims to determine the validity of potential fraud.
• Gather and analyze evidence, including financial records, witness statements, and public records.
• Conduct interviews with claimants, witnesses, and other parties involved in suspicious claims.
• Prepare detailed investigation reports outlining findings, evidence, and recommendations for further action.
• Collaborate with legal counsel, law enforcement, and other external agencies as needed.
• Develop and implement strategies to prevent insurance fraud and educate internal teams on fraud detection.

Requirements

• Proven experience as a Fraud Investigator , preferably in the insurance sector.
• Strong understanding of insurance policies, claims processes, and common fraud schemes.
• Excellent investigative, analytical, and critical thinking skills.
• Superior interviewing and interrogation techniques.
• Proficiency in using databases and investigative tools.
• Ability to work independently and manage complex investigations in a hybrid environment.

Benefits

• Competitive salary and performance-based incentives.
• Hybrid work model providing flexibility and work-life balance.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan options.
• Opportunities for specialized training in fraud investigation techniques.