Special Claims Investigator Job at Summit Consulting, LLC
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.
Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.
Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.
Essential Job Functions and Responsibilities
- Conducts specific investigations for claims cases:
- 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.
- 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: 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 position is a field position based out of Oklahoma.
Company:
SCI Summit Consulting, LLCBenefits:
We offer competitive healthcare, retirement and paid time off benefits.
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