Senior Special Casualty Claims Investigator

Great American Insurance Group; United States; Remote; USD 85,000 - 100,000; Full time

Job summary

A leading insurance company is seeking a Senior Special Casualty Claims Investigator. This fully remote role involves detecting and preventing fraudulent claims through meticulous investigation and data analysis, ensuring accurate claims settlements. Candidates should have at least 6 years of experience in casualty claims handling and a relevant Bachelor’s degree. The salary range is between $85,000 and $100,000, with a competitive benefits package.

Benefits

Medical, dental, and vision plans

Paid parental leave

401(k) plan with company match

Qualifications

• Minimum of 6 years of casualty claim handling experience.
• Experience handling a litigation case load of complex casualty claims.
• Completion of a professional designation preferred, such as CIFI or CFE.

Responsibilities

• Detect and prevent fraudulent claims through investigation.
• Prepare comprehensive reports summarizing investigation findings.
• Ensure claims are settled accurately and fairly.

Skills

Claims investigation laws and regulations

Interpersonal and communication skills

Analytical skills

Education

Bachelor’s Degree in Criminal Justice or related field

Job description

Overview

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

Great American's Special Investigation Unit (SIU) stands to prevent, detect and investigate instances of potential insurance claims fraud, collaborating with business units in the proper handling and required reporting of fraudulent claims while exhibiting high professional standards of conduct.

Our SIU team is looking for a Senior Special Casualty Claims Investigator to join their team. The position is fully remote and requires up to 10% travel.

Essential Job Functions and Responsibilities

• Detects and prevents fraudulent claims through meticulous investigation and complex analysis.

• Analyzes and interprets data to identify inconsistencies, potential fraud, and the overall legitimacy of claims.

• Prepares comprehensive reports summarizing investigation findings and recommends claim approval or denial. Evaluates claims and may recommend courses of action to management.

• Ensures claims are settled accurately and fairly, minimizing fraudulent activities and protecting the company’s financial interests.

• May present evidence and/or deliver testimony in situations where law enforcement agencies seek prosecution.

• Contributes to the continuous improvement of investigation processes and techniques, enhancing overall efficiency and effectiveness.

• May contribute to the development of program awareness initiatives or facilitate training sessions focused on the detection, deterrence, and prevention of fraudulent activities.

• Performs other duties as assigned.

Job Requirements

• Experience handling a litigation case load of complex casualty claims.

• Bachelor’s Degree in Criminal Justice, Risk Management and Insurance, Business Administration, or a related field or equivalent experience.

• Generally, a minimum of 6 years of casualty claim handling experience with some Criminal Investigation or Fraud Detection experience.

• Continuing progress toward and/or the completion of a professional designation preferred, such as Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner, or Private Investigator license from a National Investigation Organization or State Agency.

Scope of Job/Qualifications

• Works within broad limits and authority on assignments of highly complex technical complexity and coordination.

• Strong knowledge of Claims investigation laws and regulations. Ability to identify and address subtle details that could impact the outcome of an investigation.

• Excellent interpersonal and communication skills to collaborate with appropriate parties to ensure thorough and accurate claims settlements.

Business Unit

Corporate Claims

Salary Range

$85,000.00 -$100,000.00

Benefits

Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.

We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.

Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.