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Special Investigative Unit Field Investigator

Investigate and validate the claims of our customers, provide world-class customer service to our internal and external customers, and detect and deter all efforts to commit insurance fraud against our customers and Fred Loya Insurance.


Essential Duties and Responsibilities


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1.????? Investigate claims and complaints by customers, internal and external. Analyze and determine whether fraudulent behavior has occurred.? This would include, among others, interviewing and obtaining witness statements, analyzing and canvassing the scene of the accident or theft, inspecting vehicles, and working with law enforcement or NICB.?


2.????? Demonstrate and utilize strong analytical skills and the ability to successfully investigate common fraud schemes.


3.????? Develop investigative strategies.


4.????? Review referrals and evaluate claims and underwriting information.


5.????? Identify appropriate resources and investigative strategies.


6.????? Serve as a resource to the sales, appraisers, and claim staff.


7.????? Develop, implement and deliver fraud awareness training throughout the company.


8.????? Identify and establish external relationships with industry, law enforcement, and other contacts involved in fraud investigations, detection, and prevention


9.????? Other duties as assigned by management or as needed.


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Qualifications/Requirements


1.????? Strong organizational skills, able to work well under deadlines in a changing environment, and perform multiple tasks effectively and concurrently.


2.????? Demonstrate ability to work effectively independently and within a collaborative team-oriented environment using sound judgment in decision-making.


3.????? Good communication skills both oral and written.


4.????? Strong analytical skills to investigate, detect, and deter potential fraud situations.


5.????? A working knowledge of state laws and regulations pertaining to insurance fraud.


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Education/Training/Experience


1.????? Bilingual (Spanish) preferred but not required


2.????? 2 years of investigations or law enforcement.


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Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

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