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Fraud Investigation Specialist (PHOENIX)
Fraud Investigation Specialist (PHOENIX)USAA • Guadalupe, AZ, US
Fraud Investigation Specialist (PHOENIX)

Fraud Investigation Specialist (PHOENIX)

USAA • Guadalupe, AZ, US
20 hours ago
Job type
  • Full-time
Job description

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the 1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values honesty, integrity, loyalty and service define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated SIU Consultant, you will within defined guidelines and framework, provide specialized identification, investigative, analytical, and advisory services, particularly when claim or underwriting fraud is suspected. You will use various analytical and digital fraud detection tools and resources to evaluate SIU referrals and identify potential fraud within claims or policies. You will also monitor and identify fraud trends through ongoing analysis and shares findings with core SIU teams. This role is remote eligible in the continental U.S. with occasional business travel. What you'll do : Reviews data such as claims or policy files, medical bills, vendor billing, damage estimates, accident details, industry trends and environmental circumstances to identify potential fraud. Proactively identify and mitigate fraud risk through evaluation of digital and manual referrals, data sets, industry knowledge, publications, analysis of risk environment and assessment of USAA process and policies. Monitor and report on the performance of revised manual and digital fraud detection process. Utilize specialized software and tools to proactively identify suspicious patterns and trends of organized insurance fraud. Leverage referral data from manual and digital fraud detection to develop and provide recommendations to improve fraud identification effectiveness for internal teams and external partners. Develop and maintain relationships with stakeholders with internal and external stakeholders, leveraging expertise from law enforcement, NICB, and / or similar agencies to conduct impactful analysis and support operational success. Perform trend and link analysis in support of claim and policy fraud investigations and to identify potential opportunity in unidentified risks to the organization. Provide awareness training to SIU investigators regarding analytical tools and resources available in support of investigations. Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have : High School Diploma or General Equivalency Diploma. 2 years of Property & Casualty fraud related investigative experience OR proven / documented experience conducting research using data and analytics, analyzing investigative evidence, and creating a case assessment report. Demonstrated investigatory or analytical skills with experience understanding fraud schemes. Experience analyzing data and identifying patterns within Property & Casualty claims or policies. Comprehensive understanding of industry accepted red flag indicators of insurance fraud. Ability to gather broad range of evidence and conduct in depth background analysis Ability to handle sensitive and confidential information Strong verbal, written, and interpersonal communication skill. What sets you apart : Strong analytical skills to include ability to write SQL, Python and leverage analytical databases such as snowflake, Alteryx, etc. this is a strong preferred requirement. 2 years of SIU or related insurance claim / policy investigative experience, basic understanding of SIU red flags. Experience using digital fraud detection tools for analysis, to include digital fraud detection performance, outliers and development of new fraud detection rules. Ability to work individually in a fast paced environment and process large quantity of alerts / referrals with a high level of quality and accuracy in decision making. Bachelor's degree or equivalent experience considered. Excellent written and verbal communication skills, including presentation experience. Compensation range : The salary range for this position is : $77,120 - $ 147,390 . USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation : USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits : At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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Fraud Specialist • Guadalupe, AZ, US

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