Fraud Investigator — Claims & Surveillance

Metropolitan Transportation Authority (MTA); New York (NY); On-site; USD 72,000 - 90,000; Full time

Job summary

The Metropolitan Transportation Authority (MTA) in New York seeks a Claims Fraud Investigator for NYCT to detect and investigate Workers' Compensation fraud and related issues through fieldwork, surveillance, interviews, and open-source methods.

You will work with claim examiners and staff to enhance detection, prepare evidence, and support counsel with testimony and hearings, ensuring proper custody of evidence.

Qualifications

• Bachelor's degree in Arts/Sciences and 3+ years in claim investigations.
• Experience in claim investigations and related law enforcement methods.
• Knowledge of insurance claims practices and procedures.

Responsibilities

• Perform and/or monitor surveillance to gather evidence and verify information.
• Assist in training referral sources to enhance detection and intelligence.
• Research investigative matters and conduct interviews to collect relevant information.
• Support counsel through testimony and hearing/trial preparation, and maintain evidence custody.
• Prepare investigative reports documenting activity, findings, evidence, and recommendations.
• Build and maintain relationships with outside agencies and internal stakeholders for information sharing.
• Execute special assignments and undercover operations, ensuring safety and compliance.
• Performs other duties as assigned.
• Complies with all policies and standards.
• May work hours outside regular hours; observe contractors and review invoices.

Skills

Insurance claims practices

Social media investigations

Surveillance/undercover

Investigative reports

Medical claims & occupational injury

Testifying in multiple forums

Education

BA/BS in any field

3 years experience in claim investigations

Job description

The Metropolitan Transportation Authority (MTA) in New York seeks a Claims Fraud Investigator for NYCT to detect and investigate Workers' Compensation fraud and related issues through fieldwork, surveillance, interviews, and open-source methods.

You will work with claim examiners and staff to enhance detection, prepare evidence, and support counsel with testimony and hearings, ensuring proper custody of evidence.