
Fraud Investigator (Desktop)
- Manchester
- Permanent
- Full-time
- As an Insurance Fraud Investigator you will be responsible for investigating suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, brokers, lawyers, medical providers, etc, to support the Claims organisation.
- Ability to manage all aspects of the claims investigation, to include analysing facts on issues in question, thorough review of interviews and statements of witnesses, employers, claimants and other relevant witnesses.
- Obtaining and preserving physical and documentary evidence to support investigations.
- Coordinating necessary investigative techniques and resources, such as fieldwork through internal or external field resources, cognitive or virtual interviews, etc. and ensuring quality is accurate, timely and appropriate on all cases.
- Producing reports based on evidential findings, providing adjusters with the information required to progress the claim as appropriate.
- Handling caseload across relevant jurisdictions while ensuring all tasks are completed properly.
- Testifying and presenting evidence at administrative and criminal court proceedings as required.
- Establishing and maintaining professional working relationships with insured’s, lawyers, corporate employees, vendors, police and relevant fraud bodies.
- Accurately identify and record all financial impact for cases worked in the case management system
- Assisting GIS and local management as appropriate in ensuring key deliverables and business objectives are met.
- Awareness of, and adherence to, local laws regarding techniques used for information gathering in countries where operating.
- Provide intelligence feedback to claims and underwriting departments regarding loss trends and opportunities for future fraud mitigation.
- Knowledge of criminal and civil justice systems
- Ability to manage workflow to create and pursue leads that would support a fraud case
- Ability to work to tight timelines when necessary
- Demonstrable investigative-related experience essential, preferably in an insurance claims dept
- Experience of utilising automated fraud detection tools to mitigate fraud in both claims and underwriting (desirable).
- PC skills and experience with various database search systems
- Understanding of Data Protection Act and other compliance legislation