Fraud Investigator (Hybrid) 3.6 3.6 out of 5 stars Sherburne, NY 13460 The Fraud Investigator is responsible for conducting investigations and reporting suspected instances of insurance fraud. The Fraud Investigator reviews and researches evidence and documents to analyze the overall fact pattern of claim and synthesis data into professional reports with recommendations.

Duties & Responsibilities:

Conduct investigations in accordance with company, SIU, statutory, regulatory, and other legal guidelines. Identify leads and potential investigations from data, databases, and/or spreadsheets. Give regular, timely, and accurate written reports to the referring party in accordance with New York State regulation and company policies. Conduct interviews and take recorded or written statements. Verify receipts, complete activity checks, and other investigative processes with SIU resource materials such as cameras, computers, and recorders. Maintain chronological case order. Report all suspected instances of insurance fraud in accordance with regulations. Testify in court. Brief management. Maintains an accurate factual log of activities on all files. Regularly interface with law enforcement or regulatory agencies. Regular liaison between SIU Field Investigators, EFW Examiners, and Claims Examiners. Maintain technical proficiency with SIU resource materials i.e., cameras, computers, recorders, etc. Remain current in insurance investigative techniques and knowledge through course and training module as assigned. Remain familiar with civil law, criminal law, and all other laws that may impact an investigation or how to deal with the results. Other duties as assigned.

Requirements:

High School Diploma 5 years insurance claims investigation or professional investigation with law enforcement agencies. Or 7 years of professional investigation involving economic or insurance-related matters.

Skills & Qualifications:

Working knowledge of New York State regulations and company policies. Familiar with civil and criminal law and all other laws that may impact an investigation or results. Technical proficiency with cameras, computers, recorders, and all SIU resource materials. Good computer skills including electronic email and databases. Proficient Microsoft Word and Excel skills. Organized; detail oriented; investigative thought process. Excellent communication skills including verbal and written and active listening. Ability to work independently and take direction. Ability to analyze data to identify leads and potential investigations. Ability to at times work in less-than-ideal situations and locations while performing investigations.

Payband:

6 / 40 hours per week /

Hybrid Salary Range:

$47,400 - $73,700 Accepting applications until: 5/22/2025

Behaviors Preferred Team Player:

Works well as a member of a group

Loyal:

Shows firm and constant support to a cause

Leader:

Inspires teammates to follow them

Thought Provoking:

Capable of making others think deeply on a subject

Functional Expert:

Considered a thought leader on a subject

Detail Oriented:

Capable of carrying out a given task with all details necessary to get the task done well

Dedicated:

Devoted to a task or purpose with loyalty or integrity Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.