Senior Fraud Claims Investigator

AAA Auto Club Enterprises; Lincoln (RI); Presencial; USD 70.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health coverage: medical, dental, and–

401(k) with company match and pension

Tuition assistance

Floating holidays and PTO for charity

Paid parental leave

Wellness programs

Employee discounts

Descripción de la vacante

AAA Auto Club Enterprises in the United States is seeking a claims fraud investigator to oversee the investigation and disposition of potentially fraudulent claims across product lines. The role also serves as a liaison to industry bodies such as NICB and the Department of Insurance, requiring public speaking, teaching, and reporting capabilities.

The position involves developing investigative strategies, supervising field work, preparing clear investigative reports, and providing training to

Formación

• Bachelor's equivalent combination of education and experience.
• 4-6 years prior Claims experience.
• Moderate computer and line of business technical software skills.
• Advanced application of policy language as applied to coverage, liability, and settlement.
• Advanced organization and planning recognition skills.
• Advanced oral and written communication skills.
• Advanced interpersonal skills.
• Advanced interviewing and negotiation skills.
• Valid Driver's License, acceptable DMV record and minimum liability insurance - issued by state required.

Responsabilidades

• 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 investigative reports clearly outlining the issues, investigation, findings and recommendations to claims staff.
• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted; attend and/or testify 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 anti-fraud personnel to identify, articulate, and refer suspicious claims.
• The position requires discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.

Conocimientos

Oral communication

Written communication

Interpersonal skills

Negotiation

Interviewing

Organization

Planning

Computer skills

Policy language

Educación

Bachelor's equivalent

Descripción del empleo

AAA Auto Club Enterprises in the United States is seeking a claims fraud investigator to oversee the investigation and disposition of potentially fraudulent claims across product lines. The role also serves as a liaison to industry bodies such as NICB and the Department of Insurance, requiring public speaking, teaching, and reporting capabilities.

The position involves developing investigative strategies, supervising field work, preparing clear investigative reports, and providing training to