Fraud Investigator (Hybrid)

Fraud Investigator (Hybrid)

The Fraud Investigator is responsible for conducting investigations and reporting suspected instances of insurance fraud. The Fraud Investigator reviews and researches evidence and documents to analyze the overall fact pattern of claim and synthesis data into professional reports with recommendations.

Duties & Responsibilities :

• Conduct investigations in accordance with company, SIU, statutory, regulatory, and other legal guidelines.
• Identify leads and potential investigations from data, databases, and / or spreadsheets.
• Give regular, timely, and accurate written reports to the referring party in accordance with New York State regulation and company policies.
• Conduct interviews and take recorded or written statements.
• Verify receipts, complete activity checks, and other investigative processes with SIU resource materials such as cameras, computers, and recorders.
• Maintain chronological case order.
• Report all suspected instances of insurance fraud in accordance with regulations.
• Testify in court.
• Brief management.
• Maintains an accurate factual log of activities on all files.
• Regularly interface with law enforcement or regulatory agencies.
• Regular liaison between SIU Field Investigators, EFW Examiners, and Claims Examiners.
• Maintain technical proficiency with SIU resource materials i.e., cameras, computers, recorders, etc.
• Remain current in insurance investigative techniques and knowledge through course and training module as assigned.
• Remain familiar with civil law, criminal law, and all other laws that may impact an investigation or how to deal with the results.
• Other duties as assigned.

Requirements :

Skills & Qualifications :

Market range : 6 / 40 hours per week / Hybrid

Salary Range : $47,400 - $73,700

Accepting applications until : 11 / 17 / 2025