All roles

Open role

Insurance Investigator

Remote · Ethiopia Full-time

Our client, a prominent insurance organization, is seeking a meticulous and proactive Insurance Investigator to join their team in San Antonio, Texas, US . This vital role involves conducting thorough investigations into suspicious insurance claims to detect and prevent fraud, waste, and abuse. You will be responsible for gathering evidence, interviewing relevant parties, analyzing documentation, and preparing comprehensive reports to support claim decisions and legal proceedings. The ideal candidate possesses strong investigative acumen, excellent critical thinking skills, and a deep understanding of insurance fraud schemes. Key Responsibilities: Conduct comprehensive investigations into potentially fraudulent insurance claims across various lines of business. Gather and analyze evidence, including claim forms, police reports, medical records, and witness statements. Conduct interviews with claimants, witnesses, and other relevant parties. Identify and pursue leads to uncover the facts surrounding suspicious claims. Prepare detailed and objective investigation reports, documenting findings and providing recommendations. Collaborate closely with claims adjusters, legal counsel, and law enforcement agencies. Testify in court proceedings or administrative hearings when required. Maintain strict confidentiality and adhere to all legal and ethical standards. Stay abreast of emerging fraud trends, investigation techniques, and relevant legislation. Utilize various investigative tools and databases to support investigations. Qualifications: High school diploma or equivalent; a Bachelor's degree in Criminal Justice, Criminology, or a related field is preferred. Proven experience in insurance claims investigation, fraud detection, or a related investigative field. Knowledge of insurance principles, claims processes, and common fraud schemes. Strong interviewing, observation, and surveillance skills. Excellent analytical, research, and critical thinking abilities. Proficiency in report writing and documentation. Ability to work independently and manage caseloads effectively. Strong interpersonal skills and the ability to interact professionally with diverse individuals. Valid driver's license and willingness to travel as needed. High ethical standards and a commitment to maintaining confidentiality.

More open positions

Pre-employment Background Investigator - Department of Safety

Work from home Full-time role

Copy - Fraud Investigator II

Work from home Full-time role

Senior Fraud Investigator

Work from home Full-time role

Claims Fraud Investigator- SIU

Work from home Full-time role

Internal Fraud Investigator

Work from home Full-time role

[Remote] Cloud Platform Engineer

Work from home Full-time role

Instructional Designer II

Work from home Full-time role

Lead UX Designer, Emerging Experiences(Remote Or Hybrid)

Work from home Full-time role

Entry-Level Online Customer Service Representative – Remote Support, Chat & Email Specialist at careerzynith

Work from home Full-time role

Remote Customer Service Representative – Client Support & Solutions Specialist at careerzynith

Work from home Full-time role

Quality Engineering Manager

Work from home Full-time role

Part-Time Remote Customer Service Representative – Flexible Schedule for College Students at careerzynith

Work from home Full-time role

Customer Success Associate

Work from home Full-time role

Consultant Expérimenté - Transaction Services F/H

Work from home Full-time role

Billing Specialist- Home Health- Medicaid and commercial experience REQUIRED

Work from home Full-time role

Experienced Opinion Sharing and Data Entry Specialist – Remote Customer Insights and Data Management

Work from home Full-time role

AAA Medicare Insurance Counselor (SHIP) Case Manager

Work from home Full-time role

Visitor Engagement Associate job at Wildlife Conservation Society in New York City, NY

Work from home Full-time role

Experienced Full Stack Customer Experience Concierge – Remote Chat Professional

Work from home Full-time role

Remote Math Teacher

Work from home Full-time role

Senior Solutions Engineer Enterprise

Work from home Full-time role