Fraud Investigation Specialist

2 weeks ago

New Orleans, Louisiana, United States Allied Universal Compliance and Investigations Full time
Overview

Allied Universal Compliance and Investigations, a premier provider of insurance claim investigations and corporate governance solutions in North America, offers fulfilling career opportunities that instill a sense of purpose. By joining our dynamic, diverse, and inclusive team, you will contribute to a culture that positively impacts the communities and clients we serve. We provide comprehensive benefits including medical, dental, and vision coverage, life insurance, retirement plans, employee assistance programs, and various company perks for most full-time positions in compliance and investigations.

Job Description

We are seeking a dedicated Fraud Investigation Specialist to join our Special Investigations Unit (SIU). This role involves scrutinizing claims that exhibit indicators of potential fraudulent activity related to insurance claims. The Specialist will leverage their in-depth understanding of insurance policies and fraud elements to assess whether claims should be escalated to the relevant state authorities for further action.

  • Flexible work arrangements, including field and remote opportunities
  • Provision of an auto allowance and company credit card for travel expenses
  • Possession of a Private Investigator's license is mandatory prior to application

Key Responsibilities:

  • Conduct independent investigations into suspected fraudulent insurance claims across various coverage types, including workers' compensation, general liability, property and casualty, and disability.
  • Collect and analyze information utilizing discretion, along with guidance from clients and case managers, through data gathering, interviews, research, and collaboration with other SIU teams, law enforcement, and state insurance departments.
  • Maintain meticulous documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as required.
  • Prepare professional reports, memos, and correspondence that are clear, concise, and grammatically accurate.
  • Execute necessary database searches and verify the accuracy of findings.
  • Develop a strategic plan to meet assignment objectives, ensuring thorough documentation and effective communication with clients and the SIU Supervisor.

Qualifications (Required):

  • Possession of one or more of the following:
    • Bachelor's degree in Criminal Justice
    • High School diploma or equivalent with at least five (5) years of proven law enforcement experience focused on fraud investigations
  • Ability to obtain the necessary Private Investigator license as mandated by the state of employment.
  • Post-offer, successful completion of the Allied Universal Investigations training/orientation course is required.
  • A minimum of five (5) years of demonstrated experience in conducting complex insurance investigations or managing intricate insurance claims.
  • Strong understanding and application of anti-fraud legislation, insurance regulations, and compliance standards relevant to their home state and designated region.
  • Proficient in the use of laptops and mobile devices.
  • Knowledge of Special Investigative Unit (SIU) compliance.
  • Typing proficiency of 40+ words per minute with minimal errors.
  • Willingness to work varied hours, including weekends and holidays.

Preferred Qualifications (Desirable):

  • Experience in the military.
  • Background in law enforcement.
  • Experience in insurance administration.
  • Familiarity with California SIU regulations.
  • Possession of one or more of the following professional certifications:
    • Certified Fraud Examiner (CFE)
    • Certified Insurance Fraud Investigator (CIFI)
    • Fraud Claim Law Associate (FCLA)
    • Fraud Claim Law Specialist (FCLS)
    • Certified Protection Professional (CPP)
    • Associate in Claims (AIC)
    • Chartered Property Casualty Underwriter (CPCU)

Benefits:

  • Compensation range: $27 - $36 per hour.
  • Comprehensive medical, dental, vision, basic life, AD&D, and disability insurance.
  • Eligibility for enrollment in the company's 401(k) plan.
  • Seven paid holidays annually, with sick days available as required by law.
  • Vacation time accrued at an initial rate of 3.08 hours biweekly for full-time roles, with unused vacation paid out only as mandated by law.
Closing

Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status, or any other characteristic protected by law. For more information:

If you have questions regarding Equal Employment Opportunity, Affirmative Action, Diversity and Inclusion, or require assistance during the recruitment process, please reach out to our local Human Resources department.

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