8 days old

Premium Fraud Investigator(Full Time)

Beacon Mutual Insurance
Warwick, RI 02886
  • Job Code
    15706543725d9e48a4f276a1746
Job Description

Premium Fraud Investigator (Full Time)
Location: Warwick, RI

Beacon Mutual Insurance is searching for an organized, motivated professional who can effectively activate our newly created role of Premium Fraud Investigator.

As our Premium Fraud Investigator you will be responsible for identifying, coordinating, and conducting investigations of potential workers' compensation insurance premium fraud matters. This is an ideal opportunity for someone who has the capability to develop this program to full potential. If you are familiar with insurance fraud detection; able to conduct field investigations to gather evidence through investigative interviews, and have strong analytical, research and communication skills then we are looking for someone like you!

Fraud Investigation

As our Premium Fraud Investigator, you will report to and work closely with our General Counsel to provide information, evidence and recommend the best course of action on premium fraud cases. We will look to you to oversee the entire life cycle of a premium fraud investigation. You will implement investigative plans, cull through documents for evidence, and coordinate efforts aimed at encouraging compliance and closure of fraud cases. You will work closely with underwriting, claims, and legal counsel as well as state agencies and law enforcement agencies and you will act upon referrals from internal and external sources regarding potential fraud matters. You will also research and seek out potential premium fraud through other platforms and media sites.

Research and Analysis

Review financial statements and other documents to identify fraudulent evidence

Conduct investigative interviews to collect information

Research public and paid databases for information regarding company operations

Implement and utilize data analytics to help identify and track potential fraudulent subjects

Communication and Collaboration

Coordinate efforts with law enforcement, state agencies, underwriting, claims, and legal counsel

Assist in the preparation of witnesses and or testify in cases where civil litigation or criminal prosecution is pursued

Negotiate and encourage compliance with policyholder in an effort to bring closure to fraud cases

Requirements

The requirements of this position are varied, but in general we are seeking someone with a Bachelor's Degree or equivalent combination of skills and experience; 3-5 years of experience in areas related to criminal investigation, insurance premium fraud investigation and/or financial auditing experience. Of high importance is the capability to create a successful program aimed at reducing workers' compensation premium fraud. You must have a valid driver's license and satisfactory driving record, or alternative means of transportation. Also required, proficiency in Microsoft Word and Excel and case data management systems. Strong communication skills, both written and verbal are necessary.

Preferences

Our preferences for this position include: Professional designations (i.e. Certified Fraud Examiner, Private Investigator license, etc.) from a recognized national investigation organization or state agency. Experience /knowledge of financial statements and general accounting. Knowledge of insurance industry, especially workers' compensation insurance. Knowledge of investigative, surveillance and interview principles and techniques. Knowledge of RI criminal statutes and rules of criminal procedure. Bilingual skills helpful.

Why Work Here....

Competitive base salary along with a broad range of compensation initiatives

Comprehensive health plans, life insurance, and wellness programs

Generous vacation time, plus telecommuting and flexible schedule arrangements

Retirement savings plan and 401(k) educational programs

Learning and development opportunities

Friendly and supportive atmosphere

Professional environment based on knowledge sharing and teamwork

Work/Family Friendly

Dedication to the health and wellness of our employees - Beacon is a long standing winner of numerous Wellness Awards

Beacon Mutual is an EEO/AA employer





Posted: 2019-10-10 Expires: 2019-11-08
Sponsored by:
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Sponsored by:
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Premium Fraud Investigator(Full Time)

Beacon Mutual Insurance
Warwick, RI 02886

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