Anti-Fraud Investigator

11605 Haynes Bridge Rd, Alpharetta, GA 30009, USA Req #523
Wednesday, August 31, 2022

Location: Hybrid Work Model


As an Anti-Fraud Investigator, you will be responsible for identifying and conducting thorough investigations of suspicious claims, review documentation and develop investigative actions.  You will conduct field as well as desk investigations of insurance claims referred to the Special Investigative Unit from direct adjuster referral or by various analytic platforms.
 

 

What will you do? 

  • Coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement agencies Initiate referrals when a suspicious or fraudulent activity has been identified 
  • Initiate referrals to State Insurance Department, Fraud bureaus and NICB when a suspicious or fraudulent activity has been identified. 
  • Develop and present anti-fraud training programs within claims organization 
  • Travel up to 10-20% for field work 

 

What experience will you bring? 

  • Bachelor’s Degree or in-lieu of degree equivalent education, training and work-related experience 
  • Successful completion of one or more professional designations: FCLS (Fraud Claims Law Specialist), CIFI (Certified Insurance Fraud Investigator, CFE (Certified Fraud Examiner) 
  • 5+ years of experience with a law enforcement agency/SIU group and/or multi-line claims handling experience within the insurance industry 
  • Possess prior experience in the investigation of insurance fraud 
    • Possess a solid knowledge of the claims/SIU policies and procedures; exhibits sound interpretation of policies & procedures in investigating and resolving claims 
    • Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) 
    • Must possess effective verbal and written communication skills 
    • Must perform well in high-energy, dynamic and team-oriented environments 
    • Effective organization and time management skills with the ability to work under pressure and adhere to project deadlines 
  • Excellent interpersonal skills with the ability to establish working relationships with individuals at varying levels within the organization 
  • Demonstrate integrity within a professional environment 
  • Ability to adapt to new situations and learn quickly 
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    Working at Central  
     

    We pride ourselves on our long history—not just the years we’ve been in business, but the thousands of policyholders we’ve provided peace of mind to along the way. We’ve also built a reputation of being one of the top carrier choices for premier agents across the country.    

     

    None of this came about by chance. It’s all because we have a team of employees that works together to deliver the best customer service in the industry. We foster a spirit of collaboration and camaraderie. We celebrate our victories as one while still recognizing individual accomplishments and contributions. And when we see something that needs to be improved upon, we join forces to make the change.     

     

    In addition, we’ve built a structure where the customer truly is the focus. We have the systems, workflows and resources in place to offer quick turnarounds that still have a personal touch. This allows our employees to have the tools they need to excel.    

     

    Our corporate culture is shaped by our shared commitment to excellence and it’s guided by “Central Hospitality.” In the end, it’s all about relationships and you are a major part of that.

    It is the policy of Central that all recruiting, hiring, training, compensation, overtime, job classification and assignment, facilities, promotions, transfers, employee treatment and all other terms and conditions of employment shall be maintained in a manner which will not discriminate against any person because of race, color, age, sex, national origin, ancestry, religion, marital status, military status, or disability.  The applicant should respond to questions on this application in a way that will not divulge such information. #LI-Hybrid

    Location on Google Maps
    • 11605 Haynes Bridge Rd, Alpharetta, GA 30009, USA