Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
Under general supervision, this position is responsible for analyzing data to determine fraud schemes, trends and conducting major case investigations concerning non-medical systemic and organized fraud investigations in all lines of business, including: Auto, Property, General Liability and Workers Compensation. Provides investigative expertise to detect fraud, limit exposure and protect company assets. Focus is directed towards multiple complex case investigations with regional and national implications. This job does not manage staff.
Primary Job Duties & Responsibilities
Analyzes and summarizes highly technical information related to multiple complex case investigations with regional and national implications. Makes key decisions regarding the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity with regional and national impact. Proactively uses analytical skills to identify potential areas of organized fraud activity or identify areas of vulnerability to fraud to develop investigative plans and/or solutions. Assists in forecasting needs from emerging trends in the major case and/or organized fraud arena in local area. (e.g., NICB and industry alerts, leads from lines of business, etc.) May conduct missed opportunity reviews of claim files as needed (e.g., by line of business, by emerging trends, etc.). Conducts thorough insurance field investigations while managing resources with a focus on uncovering all potentially fraudulent aspects of claims Conducts technical training for investigative staff to build knowledge base in major case and/or fraud ring identification & Investigative techniques. Applies the techniques of critical thinking to prioritizes and develop investigations that have complex allegations and/or significantly financial impact to multiple claims and/or organized ring activity spanning across multiple lines of business and potentially across several states Applies Local, State and Federal statutes to ensure investigations are carried out within the requirements of applicable law and local office expectations Provides exceptional customer service by maintaining contact with business partners, customers and external resources throughout the life of each investigation. Acts as a liaison with local/state/federal law enforcement personnel, industry advocates and other companies. Serves as the subject matter expert (liaison) on fraud to business and industry partners. Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation. Establishes and maintains liaison network with public officials, law enforcement officers and others to obtain assistance in conducting investigations. Identifies cases for potential insurance fraud prosecution and submits questionable claims to the National Insurance Crime Bureau Reviews, understands and applies all applicable statutes: local, state and federal to ensure duties and assignments are carried out within the requirements of applicable law and local office expectations. Identifies and addresses investigative priorities through strategic partnerships. Prepares and conducts technical training in detecting and applying techniques to multiple complex cases. Testifies to findings. Other duties as assigned.
A minimum of five years of investigative experience; or a minimum of five years insurance claim related experience required. Valid driver's license required.
Education, Work Experience & Knowledge
Bachelor's degree preferred. Journeymen level tradesmen experience a plus.
Job Specific & Technical Skills & Competencies
Analytical skills and ability to make deductions; logical and sequential thinker. - Advanced Analytical and problem solving skills to use and interpret information and facts as well as apply critical techniques to investigative process - Advanced Effective business communication skills (Written & Verbal) - Advanced Computer literate; database, Internet and social media proficient - Advanced Interviewing skills - Advanced Computer literate; database and internet emerging social media use/search proficiency. - Advanced Conflict management skills to deal with crisis situations, hostile witnesses, etc. -Advanced Must be a self-motivated individual - Intermediate Excels at working independently, while making decisions to successfully pursue non-medical insurance fraud through establishing significant facts while preserving material that leads to the resolution of the investigation. - Intermediate Knowledge of available resources (internal and external) to assist in investigations- Advance Working level knowledge of insurance and claim operations, Commercial Lines, Personal Lines, and Workers Compensation insurance products. - Intermediate Time management and accurate record keeping - Intermediate Effective business communication skills (Written & Verbal) - Advanced -Strong case management skills and the ability to manage your own work independently. - Intermediate Adapt to changes in process and shifting priorities - Intermediate Must take ownership/initiative; significant planning and goal setting skills required - Intermediate Presentation and training skills. Intermediate Understanding of claim best practices - Intermediate Leadership, including delegation and ability to get work done through others- Intermediate Influence and conflict management skills - Intermediate
Environmental Exposure to Excess Noise - Occasionally Exposure to Dirt, Dust, Fumes, Smoke, Gases, or Other Irritating Substances - Occasionally Exposure to Variable Weather Conditions - Occasionally Operate or work around moving machinery - Frequently Work Schedules Weekend work hours - Occasionally Overnight work hours - Occasionally Holiday work hours (Federal and religious) - Occasionally Other Travel - Frequently
Operates standard office equipment - Frequently Sitting (can stand at will) - Continuously Standing - Occasionally Lifting items up to 20 pounds - Occasionally Climbing unprotected heights (ladder, rooftop, stairs, loading dock) - Occasionally Use of Keyboards, Sporadic 10-Key - Frequently Working in a confined or restricted area - Occasionally Driving Frequently
Equal Employment Opportunity Statement
Travelers is an equal opportunity employer.
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