Premium Fraud Investigator (Full Time)
Location: Warwick, RI
Beacon Mutual Insurance is searching for an organized, motivated professional who can effectively activate our newly created role of Premium Fraud Investigator.
As our Premium Fraud Investigator you will be responsible for identifying, coordinating, and conducting investigations of potential workers compensation insurance premium fraud matters. This is an ideal opportunity for someone who has the capability to develop this program to full potential. If you are familiar with insurance fraud detection; able to conduct field investigations to gather evidence through investigative interviews, and have strong analytical, research and communication skills then we are looking for someone like you!
Fraud Investigation
As our Premium Fraud Investigator, you will report to and work closely with our General Counsel to provide information, evidence and recommend the best course of action on premium fraud cases. We will look to you to oversee the entire life cycle of a premium fraud investigation. You will implement investigative plans, cull through documents for evidence, and coordinate efforts aimed at encouraging compliance and closure of fraud cases. You will work closely with underwriting, claims, and legal counsel as well as state agencies and law enforcement agencies and you will act upon referrals from internal and external sources regarding potential fraud matters. You will also research and seek out potential premium fraud through other platforms and media sites.
Research and Analysis
Review financial statements and other documents to identify fraudulent evidence
Conduct investigative interviews to collect information
Research public and paid databases for information regarding company operations
Implement and utilize data analytics to help identify and track potential fraudulent subjects
Communication and Collaboration
Coordinate efforts with law enforcement, state agencies, underwriting, claims, and legal counsel
Assist in the preparation of witnesses and or testify in cases where civil litigation or criminal prosecution is pursued
Negotiate and encourage compliance with policyholder in an effort to bring closure to fraud cases
Requirements
The requirements of this position are varied, but in general we are seeking someone with a Bachelors Degree or equivalent combination of skills and experience; 3-5 years of experience in areas related to criminal investigation, insurance premium fraud investigation and/or financial auditing experience. Of high importance is the capability to create a successful program aimed at reducing workers compensation premium fraud. You must have a valid drivers license and satisfactory driving record, or alternative means of transportation. Also required, proficiency in Microsoft Word and Excel and case data management systems. Strong communication skills, both written and verbal are necessary.
Preferences
Our preferences for this position include: Professional designations (i.e. Certified Fraud Examiner, Private Investigator license, etc.) from a recognized national investigation organization or state agency. Experience /knowledge of financial statements and general accounting. Knowledge of insurance industry, especially workers compensation insurance. Knowledge of investigative, surveillance and interview principles and techniques. Knowledge of RI criminal statutes and rules of criminal procedure. Bilingual skills helpful.
Why Work Here.
Competitive base salary along with a broad range of compensation initiatives
Comprehensive health plans, life insurance, and wellness programs
Generous vacation time, plus telecommuting and flexible schedule arrangements
Retirement savings plan and 401(k) educational programs
Learning and development opportunities
Friendly and supportive atmosphere
Professional environment based on knowledge sharing and teamwork
Work/Family Friendly
Dedication to the health and wellness of our employees Beacon is a long standing winner of numerous Wellness Awards
Beacon Mutual is an EEO/AA employer
Equal Opportunity Employer
Beacon is committed to the principles of equal opportunity as defined under federal and state law, and does not discriminate unlawfully on the basis of race, color, religion, religious creed, sex, gender, gender expression, gender identity, sexual orientation, age, national origin, ancestry, citizenship, marital status, protected veteran or disability status, physical/mental disability, genetic information, or any other characteristic protected by law. This policy applies to all recruitment, hiring, training, job assignment, upgrading, transfers, promotions, demotions, layoffs, and termination of its employees, as well as all other employment practices such as salary and benefits administration, education programs, and social and recreational programs.
Assistance for Applicants with Disabilities
Beacon is committed to ensuring our online application process provides an equal employment opportunity to all job seekers, including individuals with disabilities. If you believe you need a reasonable accommodation in order to search for a job opening or to submit an application, please contact us by calling 401-825-2611 and ask for assistance on submitting an application or searching for a job opening.
Diversity and Inclusion
Beacon is committed to diversity and inclusion and believes a diverse and inclusive environment that embraces difference cultures, beliefs, tolerance, and acceptance creates an enriching experience and contributes to new perspectives and ideas.
EEO
EEO Is The LAW Poster (PDF)
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