Special Investigation Unit Investigator

Producers National Corporation; United States; On-site; USD 65,000 - 95,000; Full time

Job summary

Producers National Corporation is seeking an Investigations Specialist to prevent and investigate insurance fraud. The role involves conducting investigations, communicating with law enforcement, and delivering educational programs to minimize losses. Candidates should have a strong background in fraud investigations and excellent analytical skills.

Benefits

Medical insurance

Vision insurance

401(k)

Disability insurance

Qualifications

• 5+ years SIU experience with an insurance carrier required.
• Ability to communicate in English and Spanish preferred.
• Strong background in insurance fraud investigations.

Responsibilities

• Conduct investigations of known or suspected acts of fraud and abuse.
• Communicate with law enforcement agencies regarding fraud cases.
• Document all appropriate case activity in tracking system.

Skills

Analytical skills

Research skills

Communication skills

Detail oriented

Multitasking

Education

College degree in Criminal Justice or related field

Tools

Word

Excel

MS Outlook

Job description

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Producers National Corporation provided pay range

This range is provided by Producers National Corporation. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$65,000.00/yr - $95,000.00/yr

Overview

Conducts investigations to effectively pursue the prevention, investigation and prosecution of insurance fraud and abuse; to recover lost funds; and to comply with state regulations mandating fraud plans and practices.

Job Duties:

• Conducts investigations of known or suspected acts of fraud and abuse.
• Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to fraud cases.
• Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc.
• Facilitates the recovery of the company and customer money lost because of fraud matters.
• Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company.
• Maintains open communication with constituents within and external to the company.
• Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse.
• Researches and prepares cases for clinical and legal review.
• Documents all appropriate case activity in tracking system.
• Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations.

Required Qualifications:

• Strong background in insurance fraud investigations.
• Strong analytical and research skills.
• Proficient in researching information and identifying information resources.
• Strong verbal and written communication skills.
• Consistent demonstration of accuracy, thoroughness and timeliness in completing work assignments; detail oriented.
• 5 + years’ SIU experience with an insurance carrier is required.
• Ability to multitask at a high level.
• Computer savvy with proficiency in Word, Excel, MS Outlook products, Database search tools, and use in the Intranet/Internet to research information.
• Ability to utilize company systems to obtain relevant electronic documentation.

Preferred Qualifications

• Ability to communicate in English and Spanish.
• Strong background in Bodily Injury claims investigations.
• 3+ years of experience in Investigations with a Law Enforcement Agency.

Education

• College degree in Criminal Justice or a related field, or a minimum of 8 years in law enforcement or insurance.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  General Business

• Industries

  Insurance

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Disability insurance

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