Major Case Unit Investigator

Company Overview:

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.

Allied Universal is hiring a Major Case Unit Investigator. This position is responsible for completing insurance fraud investigations and quality control of the final investigative product by providing a high level of technical expertise being delivered to our clients. The position requires the candidate to develop professional relationships with supported customers at the adjuster and management level.The perfect candidate for this role will have an in-depth understanding of suspect and non-suspect claims investigations and will be able to communicate effectively with claims staff.

Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.

RESPONSIBILITIES:

Use specialized services to identify new and emerging fraud trends and provide an enhanced focus on complex claims, high-risk claim exposures, such as organized crime-rings, Complex Financial Fraud Schemes, medical provider treatment fraud, medical provider billing fraud, Corporate Investigations, Case File Reviews, Anti-Fraud Consulting, and Criminal Conspiracies involving the insurance industry.
• Conduct complex Investigations across all lines of business in the insurance industry which may involve serious injuries, extensive damages, large scale or multi-party construction defect matters or complicated coverage issues.
• Prioritize assignments, conduct necessary field interviews, and exercise independent judgment, initiative and decision making when developing and following investigative leads.
• Analyze and interpret complex and voluminous evidence and convey highly technical information effectively to others.
• Prepare and submit detailed investigative reports as necessary and make investigative recommendations in accordance with all applicable fraud statutes, case law and the policy contract.
• Assist clients as a subject matter expert/ expert witness, coordinate and attend Examinations Under Oath, and attend legal proceedings as required.
• Coordinate with local, state, and federal law enforcement and prosecutors, Department of Insurances, NICB, and other carrier SIU's.

QUALIFICATIONS (MUST HAVE):

• Must possess one or more of the following (education):
  • Bachelor's degree OR
  • High School diploma or higher with a minimum of five (5) years of complex criminal investigative experience conducting fraud/economic related analysis

• Criminal investigator
• Detective
• Special agent in a full-time capacity

• Ability to be properly licensed as a Private Investigator as required by the state where you reside.
• Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
• Ability to type 40+ words per minute with minimum error

PREFERRED QUALIFICATIONS (NICE TO HAVE):

• Five (5) years of experience as a special investigator conducting insurance claim analysis and investigations with a carrier, third-party administrator and/or vendor contracted special investigations unit, plus one year conducting complex investigations.
• One or more of the following professional industry certifications:
• Certified Fraud Investigator (CFE)
• Certified Insurance Fraud Investigator (CIFI)
• Fraud Claim Law Associate (FCLA)
• Fraud Claim Law Specialist (FCLS)
• Certified Financial Crime Investigator (CFCI)

BENEFITS:

• Medical, dental, vision, basic life, AD&D, and disability insurance
• Enrollment in our company's 401(k)plan, subject to eligibility requirements
• Seven paid holidays annually, sick days available where required by law
• Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.