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Great American Insurance Group

Special Claims Desk Investigator

Reposted 9 Days Ago
Remote
Hiring Remotely in USA
70K-80K Annually
Mid level
Remote
Hiring Remotely in USA
70K-80K Annually
Mid level
The Special Claims Desk Investigator investigates potential insurance claims fraud, prepares reports, coordinates with law enforcement, and trains staff on fraud detection.
The summary above was generated by AI

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

Great American's Special Investigation Unit (SIU) stands to prevent, detect and investigate instances of potential insurance claims fraud, collaborating with business units in the proper handling and required reporting of fraudulent claims while exhibiting high professional standards of conduct.

Our Special Investigation Unit is looking for a Special Claims Desk Investigator to join their Major Case Unit team. This individual will work fully remote.

Essential Job Functions and Responsibilities

  • Conducts specific investigations for claims cases involving suspected ring activity:

    • Investigates all suspect fraud referrals.

    • Secures necessary information (i.e., reports, policies, appraisals, releases, statements, or other documents) to assist in the investigation of claims.

    • Identifies trends and patterns of suspected fraudulent activity.

    • May personally handles field investigations or assigns field work (i.e., surveillance, statements, etc.) to independent investigation firms.

    • Coordinates efforts with law enforcement agencies, state agencies, Claims personnel, and counsel.

  • Prepares investigation reports and detailed comprehensive reports.  Evaluates claims and recommends courses of action to management.

  • May provide evidence and/or testify in cases where law enforcement agencies pursue prosecution.

  • May assist in developing program awareness or conducting training on the detection, deterrence, and prevention of fraud.

  • May provide guidance to less experienced staff and serve as a resource to other functional areas.

  • Performs basic searches and prepares basic reports, utilizing databases, and technology that support investigations:

    • May participate in identifying enhancements to improve performance and functionality of technology applications.

    • May participate in testing the application.

  • Performs other duties as assigned. 

Job Requirements

  • Education: Bachelor’s Degree or equivalent experience.

  • Field of Study: Law Enforcement, Criminal Justice, Liberal Arts, Business, Computer Science or a related discipline.

  • Experience: Generally, 3 to 6 years of related experience, including Criminal Investigation or Fraud Detection experience.  Professional designation (i.e., Certified Fraud Examiner, Private Investigator license, etc.) from a recognized National Investigation Organization or State Agency preferred. 

This job is non-exempt in California and Washington

Business Unit:

Corporate Claims


Salary Range:

$70,000.00 -$80,000.00

Benefits:

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

 

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

 

*Excludes seasonal employees and interns.

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