Claims Special Investigator III

The position requires a high degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.

Job Duties

• Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims.

• Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, background search, and research as appropriate.

• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings/recommendations to claims staff.

• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.

• Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.

• Provide training to claims staff on insurance fraud and industry trends. Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.

Qualifications

• Bachelor’s or equivalent combination of education and experience preferred

• 4-6 Year prior Claims experience required

• Moderate computer and line of business technical software skills required.

• Advanced application of policy language as applied to coverage, liability, and settlement.

• Advanced organization and planning recognition skills required.

• Advanced oral and written communication skills required.

• Advanced interpersonal skills required.

• Advanced interviewing and negotiation skills required.

• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State required.