Insurance fraud investigator Jobs in USA

ADP is hiring a Senior Fraud, Client Svc & Prod Supt Consultant - Wisely Card Product in our Employee Financial Solutions organization.

The Senior Fraud Analyst serves as a technical expert and investigative resource for the Wisely Card product. This role is responsible for in-depth analysis of complex fraud cases, advanced data analysis and reporting, and providing consultative support to internal teams and external partners. The ideal candidate will leverage strong Excel skills and investigative expertise to resolve issues, improve processes, and support operational excellence.

Ready to #MakeYourMark? Apply now!

WHAT YOU'LL DO : Responsibilities

Conduct in-depth investigations of complex fraud cases, using advanced analytical and investigative techniques

Utilize strong Excel skills for data analysis, reporting, and metrics to identify trends and support business decisions

Assist with developing, implementing, and optimizing fraud rules (including Feedzai) in collaboration with vendors and internal stakeholders

Provide second-tier support and subject matter expertise to internal teams and external partners

Develop and maintain reports, dashboards, and presentations to communicate findings and recommendations

Collaborate with vendors and internal stakeholders to optimize fraud prevention strategies and resolve issues

Identify process gaps and propose solutions to enhance fraud detection and mitigation

Support compliance initiatives, audits, and regulatory reporting as required

Communicate effectively with senior leaders to provide updates and recommendations

Mentor colleagues and share best practices in fraud investigation and analytics

Act as a resource for project-oriented assignments and cross-functional initiatives

TO SUCCEED IN THIS ROLE : Requirements

This role is located in our San Dimas, CA office. We support a hybrid working arrangement (3 days in the office minimum with 2 days at home).

5+ years of experience in fraud investigation, risk management, or compliance

Strong Excel skills and technical proficiency in data analysis and reporting

Demonstrated expertise in investigative techniques and problem-solving

Experience supporting internal and external stakeholders in a complex business environment

Experience with fraud monitoring, fraud detection and interpretation.

Experience with fraud rules development, and optimization, including Feedzai or similar tools.

Excellent written and verbal communication skills, including the ability to communicate with Senior Leadership and cross-functional partners

Ability to work independently and manage multiple priorities

Proven ability to lead projects and drive operational changes

Visionary mindset with the ability to anticipate issues, and implement system changes

A college degree is great but not required. What's more important is having the skills to do the job. Other acceptable experiences could include :

Experience noted above, OR

Military Experience. We recognize and appreciate the unique talents and experiences Veterans bring to the table. We value the discipline, commitment, and problem-solving abilities you developed and are excited to provide an environment where you can continue to make a meaningful impact

Bonus points for these : Preferred Qualifications

Advanced degree

Professional Certifications : Certified Fraud Examiner (CFE), Certified Anti-Money Laundering Specialist (CAMS).

Experience with the following tools : Feedzai or similar, Threat Metrix, Visa, LexisNexis

Background in payroll, implementation, and / or contact center operations is a plus.

Excellent communication skills

Fast learner

Ability to influence

Analytical

Base salary offers for this position may vary based on factors such as location, skills, and relevant experience. Some positions may include additional compensation in the form of bonus, equity or commissions. We offer the following benefits : Medical, Dental, Vision, Life Insurance, Matched Retirement Savings, Wellness Program, Short-and Long-Term Disability, Charitable Contribution Match, Holidays, Personal Days & Vacation, Paid Volunteer Time Off, and more. The compensation for this role is USD $59,100.00 - USD $120,200.00 / Year

• Actual compensation will not be less than the applicable minimum wage or minimum exempt salary requirement under federal, state and local laws.

A little about ADP : We are a comprehensive global provider of cloud-based human capital management (HCM) solutions that unite HR, payroll, talent, time, tax and benefits administration and a leader in business outsourcing services, analytics, and compliance expertise. We believe our people make all the difference in cultivating a down-to-earth culture that embraces our core values, welcomes ideas, encourages innovation, and values belonging. We've received recognition for our work by many esteemed organizations, learn more at ADP Awards and Recognition (https : / / www.adp.com / about-adp / awards-and-recognition.aspx) .

Diversity, Equity, Inclusion & Equal Employment Opportunity at ADP : ADP is committed to an inclusive, diverse and equitable workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including : race, color, genetic information, creed, national origin, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, ancestry, age, marital status, protected veteran status or disability. Hiring decisions are based upon ADP's operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance.

Ethics at ADP : ADP has a long, proud history of conducting business with the highest ethical standards and full compliance with all applicable laws. We also expect our people to uphold our values with the highest level of integrity and behave in a manner that fosters an honest and respectful workplace. Click https : / / jobs.adp.com / life-at-adp / to learn more about ADP's culture and our full set of values.