SIU Field Investigator - Central and Eastern NC

Davita Inc.; North Carolina; On-site; USD 60,000 - 80,000; Full time

Job summary

A leading company in the insurance sector is seeking a Special Investigator to oversee claims investigations, focusing on identifying and mitigating fraud. The role involves analyzing evidence, coordinating with law enforcement, and maintaining detailed reports. Ideal candidates will have strong investigative skills and the ability to work across multiple states in North Carolina.

Benefits

Meal Subsidy

401(K) with dollar for dollar match

Tuition Reimbursement program

Generous Paid-Time Off

Group Medical, Dental, Vision, Life insurance

Employee Assistance programs

Gift matching program for charitable giving

Qualifications

• 2+ years related work experience required, 4+ preferred.
• Previous experience in claims investigations, preferably auto.
• Understanding of state and federal fraud laws.

Responsibilities

• Conduct claims investigations on suspect or inflated claims.
• Compile and analyze information from internal/external sources.
• Communicate with law enforcement and fraud agencies.

Skills

Investigative Skills

Communication Skills

Analytical Skills

Education

Bachelor's degree or equivalent work experience

Degree in Police Science, Police Administration or Criminal Justice

Job description

Creates and maintains an ongoing awareness on the part of all claim file handlers toward recognition of "red flags" in claim cases, leading to the detection, investigation and mitigation of potentially fraudulent and/or inflated claims. Performs a variety of duties and responsibilities to bring about resolution, compromise, denial and/or prosecution of fraudulent claims. Responsible for the assignment to independent contractors for specific antifraud investigation. Is accountable for controlling costs for contracted activities.

The ideal candidate's preferred location for this position is in the Raleigh/Durham,Smithfield,Goldsboro, Rocky Mount,Greenvilleor Wilson, NC areas with regular travel required in an around central and eastern North Carolina.

What You'll Do:

As a Special Investigator, you will conduct basic to moderately complex claims investigations on potentially suspect/inflated auto, workers' compensation, and commercial claims which may include but is not limited to compiling and analyzing information from internal and external sources, conducting interviews, hiring independent contractors, and referring claims to various law enforcement entities as required by law.

• Investigate claims, both inside and outside the home office, to identify suspect or inflated claims across all lines of business. This may include conducting scene investigations, taking recorded statements, assigning independent contractors, etc.

• Compile and analyze data and information from these internal and external sources to aid in making suspect claims decisions that adhere to state and federal laws. Verify legitimacy of documents as necessary.

• Conduct recorded interviews and examinations under oath of insureds, claimants, and witnesses for claims that involve suspicious indicators.

• Maintain detailed investigation notes within SIU case management and claim systems, prepares summary reports to capture findings and recommends course of action to management which may include referring to law enforcement.

• Communicate with company, industry and law enforcement fraud agencies (i.e. NICB, Index Bureau, FBI, etc.)

• Communicate non-confidential material to claim staff concerning conclusions on suspicious claims submitted to the SIU.

• Represents the company in court appearances as a possible witness on suspected fraudulent claims, including state and/or federal courts or grand jury hearings.

• Motivate the claim staff to combat fraud and inflated claims using techniques such as creating office banners and visual aids, publishing specific case results and conducting meetings

What it Takes:

• Bachelor's degree or equivalent work experience, degree in Police Science, Police Administration or Criminal Justice beneficial.

• 2+ years of related work experience required,4+ preferred

• Previous experience in claims investigations is highly preferred, with a preference for background is auto claims

• The ability to speak both Spanish and English is preferred

• Ability to travel as necessary to satisfactory complete their job responsibilities as assigned.

• Strong investigative skills along with ability work effectively with members of the claim staff and the law enforcement community.

• Strong written and oral communication skills and the creativity to recognize potential fraud and develop a reasonable plan for investigating potential fraud cases.

What You'll Receive:

At Sentry, your total rewards go beyond competitive compensation. Below are some benefits and perks that you'll receive.

• As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.

• Meal Subsidy available for associates who report to an office.

• 401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future.

• Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program

• Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off

• Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle.

• Well-being and Employee Assistance programs

• Sentry Foundation gift matching program to encourage charitable giving.

About Sentry:

We take great pride in making Forbes' list of America's Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction.

Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, we're one of the largest and financially strongest mutual insurance companies in the United States. We're rated A+ by A.M. Best, the industry's leading rating authority.

Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth.

Get ready to own your future at Sentry. Opportunities await!

Joe Larsen

Talent Acquisition Specialist

[e-mail]

Equal Employment Opportunity

Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.