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Insurance Fraud Investigator

2 months ago

Chicago Illinois, United States AmTrust Financial Services, Inc. Full time
Job Title: Insurance Fraud Investigator

Overview:

The Insurance Fraud Investigator will review and investigate referrals to AmTrust SIU to identify any suspicious indicators to evaluate for the potential of insurance fraud (perpetrated by claimants, insured, agents, brokers, providers). The Insurance Fraud Investigator will be responsible for all Desktop Investigative activities related to the investigation of the file, communication with Law Enforcement, Departments of Insurance and other Carriers. Maintains a solid understanding of AmTrust's mission, vision, and values. Upholds the standards of the AmTrust organization.

Responsibilities:
  • Evaluate investigative referrals to determine if suspicious elements are present and justify an SIU investigation.
  • Collaborates closely with underwriting, audit and claims personnel to evaluate all aspects of a referral and determine an investigative path, and documents investigative plan.
  • Conducts Investigative/Fraud related training to meet regulatory requirements or other related topics.
  • Tracks and documents all investigative activities and results.
  • Conducts in-depth investigative searches via designated tools, and conduct telephonic investigations to develop facts in all cases.
  • Provides professional, timely and courteous communication and service to external clients and cross-departmental staff to successfully resolve issues pertaining to SIU and investigative referrals.
  • Draft referrals to be submitted to state agencies when evidence is identified to indicate potential insurance fraud.
  • Monitor completed investigations for impacts and prosecutorial judgements.
  • Keeps current with market trends and demands.
  • Performs other functionally related duties as assigned.
Qualifications:
  • Required:
    • An Associate's or Bachelor's degree in criminal justice or a related field from an accredited college or university OR 5+ years of insurance claims investigation experience OR professional investigation experience with law enforcement agencies OR 7+ years of professional investigation experience.
    • Demonstrated experience with commercial casualty, property, automobile, and workers' compensation insurance products.
    • Demonstrated ability to interpret and analyze large amounts of data and make an informed, calculated decisions.
    • Respect for confidential information.
    • Performs other functionally related duties as assigned.
    • Excellent organizational, leadership, communication, and time management skills.

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time.

What We Offer:
  • AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities.
  • Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
  • AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected.
  • This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.
  • AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice.