Senior Special Investigator – Waterloo, Ontario

Heartland Farm Mutual Inc.; Waterloo; On-site; CAD 60,000 - 100,000; Full time

Job summary

An established industry player in the insurance sector is seeking a Senior Special Investigator to join their dynamic Claims Department. In this pivotal role, you will independently investigate complex and high-risk claims, focusing on suspected fraudulent activity. Your expertise will guide decision-making and risk assessment while you collaborate with internal teams and external agencies. This position offers a unique opportunity to make a significant impact in fraud detection and contribute to training programs that enhance claims handling practices. If you are passionate about making a difference in a supportive environment, this role is for you.

Qualifications

• Experience in investigating complex claims, especially related to fraud.
• Strong analytical skills to assess coverage and policy terms.

Responsibilities

• Independently investigate high-risk claims with suspected fraud.
• Prepare comprehensive reports and provide expert recommendations.

Skills

Investigative Skills

Fraud Detection

Analytical Skills

Communication Skills

Education

Bachelor's Degree

Certification in Fraud Investigation

Tools

Claims Management Software

Reporting Tools

Job description

Located in Ontario and Nova Scotia, Heartland Mutual Insurance strives to be the Best Mutual. Our team of talented and dedicated professionals challenge the norm and strive to be extraordinary. It’s all about fulfilling our promise with a personal approach. With our team, you’ll bring this purpose to life every day by living our values, being open to change, and pursuing your career aspirations.

Heartland Mutual Insurance has an excellent opportunity in our Claims Department for a Senior Special Investigator.

What you will do…

• Independently investigate complex and high-risk claims with suspected fraudulent activity.
• Manage an investigative claims caseload, actively making coverage determinations, adjusting reserves, and directly handling claims when appropriate.
• Prepare comprehensive reports summarizing investigative findings, evidence gathered, and recommendations for claims disposition.
• Partner closely with UW to evaluate issues, assessing impacts on coverage and policy terms.
• Provide expert recommendations to UW for effective risk assessment and decision-making.
• Lead proactive fraud detection initiatives, identifying emerging trends and high-risk indicators.
• Collaborate closely with Claims team to provide training and guidance on fraud recognition and early intervention strategies.
• Develop and maintain strong relationships with external law enforcement agencies, industry fraud bureaus, and investigative networks to enhance fraud detection capabilities.
• Maintain meticulous documentation and audit trails for all investigative activities.
• Engage actively with internal stakeholders to provide investigative expertise and insights.
• Contribute to training programs focused on fraud awareness, investigative techniques, and claims handling best practices.
• Collaborate with the Manager, Corporate Claims, to establish robust reporting systems capturing investigative outcomes, fraud trends, and financial impacts.

Intrigued? We can’t wait to hear from you!

If you have the qualifications we are seeking and would thrive in a work environment where you are valued and respected, please apply on the company website. Accommodations are available on request for candidates taking part in all aspects of the selection process.

A Place Where YOU Can Make a Difference! Proudly Canadian. Mutually Owned.