insurance fraud investigator

State of New Hampshire

<div><div>State of New Hampshire Job Posting
Insurance Department
Legal Division
21 S Fruit Street, Suite 14, Concord, NH 03301 
SENIOR INSURANCE FRAUD INVESTIGATOR
Position #9U545 
 
$69,255.00/annually - $96,385.00/annually 
 
 
*See total compensation information at the bottom of announcement. 
</div> 
The State of New Hampshire, Insurance Department, Legal Division has a full-time vacancy for Senior Insurance Fraud Director. 
 
SUMMARY:
To investigate allegations of insurance-related criminal activity, participate in the collection and securing of evidence and prepare criminal cases for prosecution throughout the State of New Hampshire. 
 
YOUR EXPERIENCE COUNTS : Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education. 
 
 
PREFERRED QUALIFICATIONS:
Education: Bachelor's degree from a recognized college or university with major study in business administration, insurance, statistics, accounting, criminal justice, law, finance, economics or a related field. Each additional year of approved formal education may be substituted for one year of required work experience.
Experience: Five years of experience in law enforcement performing fraud investigations and/or undercover operations, or in the insurance industry performing statistical analysis, underwriting, claims adjudicating and accounting with specialization in the areas of health, life, disability, property and casualty insurance. Each additional year of approved work experience may be substituted for one year of required formal education.
License/Certification: Must possess a valid driver's license and/or have access to transportation for use in statewide travel.
Other Requirements: None
Trainee Option: Candidates with an equivalent combination of 4+ years of relevant education and experience after completion of high school may be considered and hired in &lsquo;trainee status&rsquo; for this position. 
 
RESPONSIBILITIES:
Conduct criminal investigations of alleged insurance fraud or other insurance-related criminal activity including theft, forgery, and misapplication of property, to uncover violations of fiduciary responsibilities and perjury relating to all lines of insurance. 
 
Examine and analyze complex insurance company, provider and Agent/Producer records, claims information and financial statements for potential fraud. 
 
Complete field canvasses and utilize databases to locate witnesses and suspects developed throughout investigations in order to conduct interviews and/or interrogations. 
 
Collect evidence by various means including search warrants, subpoenas, 1-party intercepts, and photography; ensure evidence is cataloged, properly packaged and sealed to protect from tampering, and securely stored. 
 
Conduct and/or participate in undercover and sting operations at such places as medical providers&rsquo; offices, body shops and insurance agencies, and assist law enforcement agencies upon request. 
 
Develop and implement criminal investigations and prosecution plans in conjunction with prosecuting attorneys, both state and federal, to achieve successful prosecutions for matters involving insurance-related crimes. 
 
Provide testimony in both federal and state courts as an expert witness to summarize and give opinion on evidence and information. 
 
Draft search warrant affidavits for court approval; collaborate with law enforcement agencies and assist in the execution of the search warrants. 
 
Perform research and draft new legislation and regulations that directly affect the mission of the Fraud Unit in its duties to deter and combat insurance fraud. 
 
Develop and present training programs to insurance carriers and law enforcement agencies, as well as the general public to help address fraud awareness. 
 
DISCLAIMERS :
The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that job title.
When applicable, the work of an employee in trainee status in this position shall be overseen by a fully qualified individual. An employee in trainee status shall meet the minimum qualifications within the period of time specified on the SJD, not to exceed one year of being hired into this position. 
 
For position-related questions, please contact Roni Karnis, Esq., General Counsel, at Roni.M.Karnis@ins.nh.gov.
For application-related questions, please contact Katrina Gagne, Human Resources Technician, at Katrina.L.Gagne@ins.nh.gov. 
 
*TOTAL COMPENSATION INFORMATION
The State of NH total compensation package features an outstanding set of employee benefits, including:
HMO or POS Medical and Prescription Drug Benefits:
The actual value of State-paid health benefits and the amount of employee health benefit contributions may vary depending on the type of plan selected and the bargaining unit with which a position is associated.
See this link for details on State-paid health benefits:
https://www.das.nh.gov/hr/benefits.aspx 
 
Value of State's share of Employee's Retirement: 12.87% of pay 
 
Other Benefits:
<ul><li>Dental Plan at minimal cost for employees and their families ($500-$1800 value)
</li></ul><ul><li>Flexible Spending healthcare and childcare reimbursement accounts
</li></ul><ul><li>State defined benefit retirement plan and Deferred Compensation 457(b) plan
</li></ul><ul><li>Work/life balance flexible schedules, paid holidays and generous leave plan
</li></ul><ul><li>$50,000 state-paid life insurance plus additional low-cost group life insurance
</li></ul><ul><li>Incentive-based Wellness Program (ability to earn up to $500)
</li></ul>Total Compensation Statement Worksheet:
https://www.das.nh.gov/jobsearch/compensation-calculator.aspx 
 
Want the specifics? Explore the Benefits of State Employment on our website:
https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf 
 
https://www.das.nh.gov/hr/index.aspx 
 
EOE
TDD Access: Relay NH 1-800-735-2964</div>

SENIOR INSURANCE FRAUD INVESTIGATOR

Allied Universal Compliance and Investigations

<div>Major Case Unit Investigator<h2 class="jobSectionHeader">
Overview</h2>
Company Overview:
Advance Your Career in Insurance Claims with Allied Universal&reg; Compliance and Investigation Services. Allied Universal&reg; Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.<h2 class="jobSectionHeader">
Job Description</h2>
Allied Universal&reg; is hiring a Major Case Unit Investigator. This position is responsible for completing insurance fraud investigations and quality control of the final investigative product by providing a high level of technical expertise being delivered to our clients. The position requires the candidate to develop professional relationships with supported customers at the adjuster and management level.The perfect candidate for this role will have an in-depth understanding of suspect and non-suspect claims investigations and will be able to communicate effectively with claims staff. 
hourly rate of pay $35 - $40 / hr 
RESPONSIBILITIES:
<ul><li>Use specialized services to identify new and emerging fraud trends and provide an enhanced focus on complex claims, high-risk claim exposures, such as organized crime-rings, Complex Financial Fraud Schemes, medical provider treatment fraud, medical provider billing fraud, Corporate Investigations, Case File Reviews, Anti-Fraud Consulting, and Criminal Conspiracies involving the insurance industry.</li>
<li>Conduct complex Investigations across all lines of business in the insurance industry which may involve serious injuries, extensive damages, large scale or multi-party construction defect matters or complicated coverage issues.</li>
<li>Prioritize assignments, conduct necessary field interviews, and exercise independent judgment, initiative and decision making when developing and following investigative leads.</li>
<li>Analyze and interpret complex and voluminous evidence and convey highly technical information effectively to others.</li>
<li>Prepare and submit detailed investigative reports as necessary and make investigative recommendations in accordance with all applicable fraud statutes, case law and the policy contract.</li>
<li>Assist clients as a subject matter expert/ expert witness, coordinate and attend Examinations Under Oath, and attend legal proceedings as required.</li>
<li>Coordinate with local, state, and federal law enforcement and prosecutors, Department of Insurances, NICB, and other carrier SIU's.</li></ul>
QUALIFICATIONS (MUST HAVE):
<ul><li>Must possess one or more of the following (education):<ul><li>
Bachelor's degree OR</li>
<li>High School diploma or higher with a minimum of five (5) years of complex criminal investigative experience conducting fraud/economic related analysis</li></ul></li><li><ul><li><ul><li>
Criminal investigator</li>
<li>Detective</li>
<li>Special agent in a full-time capacity</li></ul></li></ul></li></ul><ul><li>
Ability to be properly licensed as a Private Investigator as required by the state where you reside.</li>
<li>Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course</li>
<li>Ability to type 40+ words per minute with minimum error</li></ul>
PREFERRED QUALIFICATIONS (NICE TO HAVE):
<ul><li>Five (5) years of experience as a special investigator conducting insurance claim analysis and investigations with a carrier, third-party administrator and/or vendor contracted special investigations unit, plus one year conducting complex investigations.</li>
<li>One or more of the following professional industry certifications:</li><li><ul><li>
Certified Fraud Investigator (CFE)</li>
<li>Certified Insurance Fraud Investigator (CIFI)</li>
<li>Fraud Claim Law Associate (FCLA)</li>
<li>Fraud Claim Law Specialist (FCLS)</li>
<li>Certified Financial Crime Investigator (CFCI)</li></ul></li></ul>
BENEFITS:
<ul><li>Medical, dental, vision, basic life, AD&amp;D, and disability insurance</li>
<li>Enrollment in our company's 401(k)plan, subject to eligibility requirements</li>
<li>Seven paid holidays annually, sick days available where required by law</li>
<li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.</li></ul><h2 class="jobSectionHeader">
Closing</h2>
Allied Universal&reg; is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices. 
<h2 class="jobSectionHeader">Requisition ID</h2> 
2026-1536795</div>

Major Case Unit Investigator

<div>Major Case Unit Investigator<h2 class="jobSectionHeader">
Overview</h2>
Company Overview:
Advance Your Career in Insurance Claims with Allied Universal&reg; Compliance and Investigation Services. Allied Universal&reg; Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.<h2 class="jobSectionHeader">
Job Description</h2>
Allied Universal&reg; is hiring a Major Case Unit Investigator. This position is responsible for completing insurance fraud investigations and quality control of the final investigative product by providing a high level of technical expertise being delivered to our clients. The position requires the candidate to develop professional relationships with supported customers at the adjuster and management level.The perfect candidate for this role will have an in-depth understanding of suspect and non-suspect claims investigations and will be able to communicate effectively with claims staff. 
RESPONSIBILITIES:
<ul><li>Use specialized services to identify new and emerging fraud trends and provide an enhanced focus on complex claims, high-risk claim exposures, such as organized crime-rings, Complex Financial Fraud Schemes, medical provider treatment fraud, medical provider billing fraud, Corporate Investigations, Case File Reviews, Anti-Fraud Consulting, and Criminal Conspiracies involving the insurance industry.</li>
<li>Conduct complex Investigations across all lines of business in the insurance industry which may involve serious injuries, extensive damages, large scale or multi-party construction defect matters or complicated coverage issues.</li>
<li>Prioritize assignments, conduct necessary field interviews, and exercise independent judgment, initiative and decision making when developing and following investigative leads.</li>
<li>Analyze and interpret complex and voluminous evidence and convey highly technical information effectively to others.</li>
<li>Prepare and submit detailed investigative reports as necessary and make investigative recommendations in accordance with all applicable fraud statutes, case law and the policy contract.</li>
<li>Assist clients as a subject matter expert/ expert witness, coordinate and attend Examinations Under Oath, and attend legal proceedings as required.</li>
<li>Coordinate with local, state, and federal law enforcement and prosecutors, Department of Insurances, NICB, and other carrier SIU's.</li></ul>
QUALIFICATIONS (MUST HAVE):
<ul><li>Must possess one or more of the following (education):</li><li><ul><li>
Bachelor's degree OR</li>
<li>High School diploma or higher with a minimum of five (5) years of complex criminal investigative experience conducting fraud/economic related analysis-</li></ul></li><li><ul><li><ul><li>
Criminal investigator</li>
<li>Detective</li>
<li>Special agent in a full-time capacity</li></ul></li></ul></li></ul><ul><li>
Ability to be properly licensed as a Private Investigator as required by the state where you reside.</li>
<li>Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course</li>
<li>Ability to type 40+ words per minute with minimum error</li></ul>
PREFERRED QUALIFICATIONS (NICE TO HAVE):
<ul><li>Five (5) years of experience as a special investigator conducting insurance claim analysis and investigations with a carrier, third-party administrator and/or vendor contracted special investigations unit, plus one year conducting complex investigations.</li>
<li>One or more of the following professional industry certifications:</li><li><ul><li>
Certified Fraud Investigator (CFE)</li>
<li>Certified Insurance Fraud Investigator (CIFI)</li>
<li>Fraud Claim Law Associate (FCLA)</li>
<li>Fraud Claim Law Specialist (FCLS)</li>
<li>Certified Financial Crime Investigator (CFCI)</li></ul></li></ul>
BENEFITS:
<ul><li>Medical, dental, vision, basic life, AD&amp;D, and disability insurance</li>
<li>Enrollment in our company's 401(k)plan, subject to eligibility requirements</li>
<li>Seven paid holidays annually, sick days available where required by law</li>
<li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.</li></ul><h2 class="jobSectionHeader">
Closing</h2>
Allied Universal&reg; is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.<h2 class="jobSectionHeader">
Requisition ID</h2> 
2026-1536807</div>

<div>Major Case Unit Investigator<h2 class="jobSectionHeader">
Overview</h2>
Company Overview:
Advance Your Career in Insurance Claims with Allied Universal&reg; Compliance and Investigation Services. Allied Universal&reg; Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.<h2 class="jobSectionHeader">
Job Description</h2>
Allied Universal&reg; is hiring a Major Case Unit Investigator. This position is responsible for completing insurance fraud investigations and quality control of the final investigative product by providing a high level of technical expertise being delivered to our clients. The position requires the candidate to develop professional relationships with supported customers at the adjuster and management level.The perfect candidate for this role will have an in-depth understanding of suspect and non-suspect claims investigations and will be able to communicate effectively with claims staff. 

RESPONSIBILITIES:
<ul><li>Use specialized services to identify new and emerging fraud trends and provide an enhanced focus on complex claims, high-risk claim exposures, such as organized crime-rings, Complex Financial Fraud Schemes, medical provider treatment fraud, medical provider billing fraud, Corporate Investigations, Case File Reviews, Anti-Fraud Consulting, and Criminal Conspiracies involving the insurance industry.</li>
<li>Conduct complex Investigations across all lines of business in the insurance industry which may involve serious injuries, extensive damages, large scale or multi-party construction defect matters or complicated coverage issues.</li>
<li>Prioritize assignments, conduct necessary field interviews, and exercise independent judgment, initiative and decision making when developing and following investigative leads.</li>
<li>Analyze and interpret complex and voluminous evidence and convey highly technical information effectively to others.</li>
<li>Prepare and submit detailed investigative reports as necessary and make investigative recommendations in accordance with all applicable fraud statutes, case law and the policy contract.</li>
<li>Assist clients as a subject matter expert/ expert witness, coordinate and attend Examinations Under Oath, and attend legal proceedings as required.</li>
<li>Coordinate with local, state, and federal law enforcement and prosecutors, Department of Insurances, NICB, and other carrier SIU's.</li></ul> 

QUALIFICATIONS (MUST HAVE):
<ul><li>Must possess one or more of the following (education):<ul><li>
Bachelor's degree OR</li>
<li>High School diploma or higher with a minimum of five (5) years of complex criminal investigative experience conducting fraud/economic related analysis-</li></ul></li><li>
<ul><li><ul><li>Criminal investigator</li>
<li>Detective</li>
<li>Special agent in a full-time capacity</li></ul></li></ul></li></ul><ul><li>
Ability to be properly licensed as a Private Investigator as required by the state where work Is completed</li>
<li>Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course</li>
<li>Ability to type 40+ words per minute with minimum error</li></ul>
PREFERRED QUALIFICATIONS (NICE TO HAVE):
<ul><li>Five (5) years of experience as a special investigator conducting insurance claim analysis and investigations with a carrier, third-party administrator and/or vendor contracted special investigations unit, plus one year conducting complex investigations.</li>
<li>One or more of the following professional industry certifications:</li><li><ul><li>
Certified Fraud Investigator (CFE)</li>
<li>Certified Insurance Fraud Investigator (CIFI)</li>
<li>Fraud Claim Law Associate (FCLA)</li>
<li>Fraud Claim Law Specialist (FCLS)</li>
<li>Certified Financial Crime Investigator (CFCI)</li></ul></li></ul>
BENEFITS:
<ul><li>Medical, dental, vision, basic life, AD&amp;D, and disability insurance</li>
<li>Enrollment in our company's 401(k)plan, subject to eligibility requirements</li>
<li>Seven paid holidays annually, sick days available where required by law</li>
<li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.</li></ul><h2 class="jobSectionHeader">
Closing</h2>
Allied Universal&reg; is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.<h2 class="jobSectionHeader">
Requisition ID</h2> 
2026-1536779</div>

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