- Career Level
- Not Specified
Responsible for identifying and handling all aspects of claims fraud investigations. This includes identifying and investigating questionable claims, insurance transactions and other risks in order to provide assistance to internal and external customers and to protect company assets and the companys policy holders.
Essential Duties and Responsibilities:
Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
- Receive referral of questionable claim/transaction and conduct an investigative Plan of Action with the referring party that meets the standards of the department
- Conduct Examination Under Oath (EUO) when required
- Communicate with others during course of investigation with updates for their input
- Document and evaluate investigative findings
- Communicate results and recommendations with the referring party
- Make applicable reports to Fraud Bureau
- Network with individuals and agencies responsible for fraud detection
- Confer with supervisor and examiners regarding any information developed regarding fraud trends
- Complete both inside and field investigative tasks
- Evaluate facts, review and determine applicable laws and regulations
- Other duties as assigned
Minimum Skills and Competencies:
The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Bachelors Degree or in-lieu of degree equivalent education, training and work-related experience
- Possess a solid command 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
- Ability to travel up to 10%
- 5+ years of experience with a law enforcement agency and/or multi-line claims handling experience within the insurance industries
- Successful completion of one or more professional designations: FCLS (Fraud Claims Law Specialist)
- Possess prior experience in the investigation of insurance fraud
About National General Holdings:
National General Holdings Corp. is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
National General is a fast paced, dynamic, and entrepreneurial organization. Our team members live by and exemplify what we call the 4Es. At National General, we are Energized, Engaged, Empowered, and we Execute every day in order to provide an exceptional experience for our customers! We are passionate about our organization and the value that we add every day. A successful candidate with National General will embody the 4Es. Our team is poised to outperform the competition. We are National General Insurance and with us you can be extraordinary! Come join our team!
Companies and Partners
Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.
In addition to a phenomenal career opportunity, National General Insurance offers an excellent benefits package including:
Medical, Dental, Vision benefits
Life and Short/Long Term Disability Insurance
401k w/ Company Match
Company Paid Holidays & Generous Time-off policy
Employee Discount Program
Career Advancement and Development Opportunities
On-site Healthcare Clinic (Winston-Salem and Cleveland offices)
On-site Fitness Center (Cleveland and Dallas offices)
Subsidized parking (Cleveland office)
National General Holdings Corp. is an Equal Opportunity (EO) employer Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas.