SIU Field Investigator - Central and Eastern NC

Davita Inc.; Goldsboro (NC); On-site; USD 55,000 - 80,000; Full time

Job summary

A leading insurance company is seeking a Special Investigator to conduct investigations on potentially fraudulent claims across various lines. The candidate will compile data, conduct interviews, and represent the company in court. With a focus on fraud detection, this role requires strong investigative skills and the ability to collaborate effectively with various stakeholders.

Benefits

401(k) plan with dollar-for-dollar match

Tuition Reimbursement

Generous Paid-Time Off

Comprehensive health benefits

Qualifications

• At least 2 years of related experience required; 4+ years preferred.
• Experience in claims investigations, especially auto claims, highly preferred.
• Ability to speak both Spanish and English is a plus.

Responsibilities

• Conduct investigations on suspect auto and workers' compensation claims.
• Compile data and conduct interviews to identify fraudulent claims.
• Represent the company in court appearances on suspected fraudulent claims.

Skills

Investigative skills

Communication skills

Collaboration

Education

Bachelor's degree in Police Science, Administration, or Criminal Justice

Job description

Creates and maintains an ongoing awareness among all claim file handlers to recognize "red flags" in claim cases, leading to the detection, investigation, and mitigation of potentially fraudulent or inflated claims. Performs various duties to resolve, compromise, deny, or prosecute fraudulent claims. Responsible for assigning independent contractors for antifraud investigations and controlling costs for contracted activities.

The ideal candidate's preferred locations are in the Raleigh/Durham, Smithfield, Goldsboro, Rocky Mount, Greenville, or Wilson, NC areas, with regular travel required around central and eastern North Carolina.

What You'll Do:

As a Special Investigator, you will conduct basic to moderately complex investigations on potentially suspect or inflated auto, workers' compensation, and commercial claims. Responsibilities include compiling and analyzing information from various sources, conducting interviews, hiring independent contractors, and referring claims to law enforcement as required.

• Investigate claims both inside and outside the office to identify suspect or inflated claims across all lines of business, including scene investigations and recorded statements.
• Compile and analyze data to assist in suspect claim decisions, ensuring compliance with laws and verifying document legitimacy.
• Conduct recorded interviews and examinations under oath with insureds, claimants, and witnesses.
• Maintain detailed investigation notes and prepare summary reports with findings and recommendations for management, including law enforcement referrals.
• Communicate with company, industry, and law enforcement fraud agencies.
• Share non-confidential findings with claim staff regarding suspicious claims.
• Represent the company in court appearances as a witness on suspected fraudulent claims, including court and grand jury hearings.
• Motivate claim staff to combat fraud through various techniques and informational materials.

What it Takes:

• Bachelor's degree or equivalent work experience; degrees in Police Science, Police Administration, or Criminal Justice are beneficial.
• At least 2 years of related experience required; 4+ years preferred.
• Experience in claims investigations, especially auto claims, is highly preferred.
• Ability to speak both Spanish and English is a plus.
• Willingness to travel as necessary.
• Strong investigative skills and effective collaboration with claim staff and law enforcement.
• Excellent written and oral communication skills, with the creativity to identify potential fraud and plan investigations.

What You'll Receive:

At Sentry, we offer competitive total rewards, including:

• In-office workspace and home office materials, including equipment.
• Meal Subsidy for associates reporting to an office.
• 401(k) plan with a dollar-for-dollar match on the first 8% and immediate vesting.
• Opportunities for education and career development through Sentry University and Tuition Reimbursement.
• Generous Paid-Time Off and Volunteer Time Off.
• Comprehensive health benefits, including Medical, Dental, Vision, Life Insurance, and Parental Leave.
• Well-being and Employee Assistance programs.
• Sentry Foundation gift matching for charitable giving.

About Sentry:

We are proud to be listed among Forbes' America's Best Midsize Employers, reflecting our commitment to job satisfaction and success. Founded in 1904, we are one of the largest and most financially stable mutual insurance companies in the U.S., rated A+ by A.M. Best.

Headquartered in Stevens Point, Wisconsin, with offices nationwide, we offer rewarding opportunities across various functions, supporting ongoing professional growth.

Join us to own your future at Sentry!

Joe Larsen

Talent Acquisition Specialist

[e-mail]

Equal Employment Opportunity

Sentry is an Equal Opportunity Employer, committed to non-discrimination regardless of race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.