investigator fraud

Dallas County

JOB DESCRIPTION
<br>This position works independently in providing support and expertise to the Assistant District Attorney in investigating moderate to complex level cases and/or cases requiring special skills.
<br>RESPONSIBILITIES
<br>1. Independently assists the assigned Assistant District Attorney in gathering pertinent data, identifying significant factors and recognizing solutions for the complex and/or specialized cases involving capital murder and high dollar value white collar crime. Reviews, researches, analyzes and evaluates complex financial data from documents received as evidence in financial crime investigations involving numerous individuals and entities engaged in fraudulent activities; extracts data and prepares complex reports to explain results; follows through on investigative leads discovered during analyses of evidential financial records.
<br><br>
2. Independently locates and develops evidence for trial or plea negotiations.
<br><br>
3. Works independently in planning and organizing work, as part of a trial or section, in preparing cases for disposition. Presents oral and/or written investigative reports on the evidence and results of financial investigations; prepares exhibits for use in the prosecution of cases.
<br><br>
4. Assists in reconstructing events, sequences and time elements in preparation of criminal cases. Testifies as an expert witness in indictments and trials.
<br><br>
5. Locates, interviews, and notifies witnesses of trial dates by means of serving subpoenas, summons and writs, and makes arrests. Coordinates transportation and lodging of trial witnesses. Checks background of witnesses that may be used during trial. Directs investigations with team members and outside agencies; conducts witness interviews to gain a detailed understanding of the case and obtain additional relevant financial information.
<br><br>
6. Collects and prepares physical evidence for trial which includes reviewing various reports such as medical autopsy and forensic reports, investigating the crime scene, reviewing criminal scene data, gathering evidence, determining what evidence needs to be analyzed and drawing informative accurate conclusions.
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7. Assists the Assistant District Attorney during jury selections and trial presentations.
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8. Supervises and trains Level I and Level II investigators; acts as lead when more than one investigator is required.
<br><br>
9. Performs other duties as assigned.
<br>QUALIFICATIONS
<br><br>
<b>Education, Experience and Training:</b><br>
Education and experience equivalent to a Bachelor’s degree from an accredited college or university in a job related field of study. Six (6) years of continuous experience in investigative law enforcement required, OR have been awarded an Advanced Peace Officer Certificate from TCOLE and no experience.
<br><br>
An individual must have on file documentation that the individual meets the following standards: a high school diploma from an accredited high school or a high school equivalency certificate (GED). “Continuous employment” is defined as current employment in a TCOLE law enforcement position with no interruption/break in service
<br><br>
.
<br><br>
<b>Special Requirements/Knowledge, Skills & Abilities:</b><br>
Must be a Certified Peace Officer and proficient in the use of a firearm. Knowledgeable of investigative techniques and ability to communicate both orally and in writing with a diverse group of individuals. Skilled at applying interviewing techniques while assisting the prosecutors in adverse or hostile conditions. Must pass criminal background investigation. Mandatory drug test prior to and during employment. Certified Fraud Examiner (CFE), Certified Public Accountant (CPA), Certified Internal Auditor (CIA), or Chartered Financial Analyst (CFA) is required. Knowledge of Generally Accepted Accounting Principles (GAAP) and standardized financial practices; federal, state and local government codes; computer systems and standardized financial/accounting software. Ability to interpret financial data and identify fraudulent activities; organize information into presentations; prepare exhibits, graphs and/or flowcharts. Must possess a valid Texas Drivers License and good driving record. Will be required to provide a copy of 10-year driving history. Must maintain a good driving record and remain in compliance with Article II, Subdivision II of Chapter 90 of the Dallas County Code.
<br><br>
<b>Physical/Environmental Requirements:</b><br>
Standard office environment 50% of the time with the remainder of time spent in a typical law enforcement street environment.

0000006745.INVESTIGATOR III (FRAUD).DISTRICT ATTORNEY 'S OFFICE

Mechanics Bank

<div><div><div>Mechanics Bank is currently searching for a full time Sr. Fraud Investigator to join our team. This role will be working on-site at either our Irvine HQ or Roseville Executive Offices.</div><div><br>
The Sr. Fraud Investigator is responsible for conducting independent investigations into suspected or actual violations of financial regulations, including but not limited to Fraud, Anti-Money Laundering (AML), Bank Secrecy Act (BSA), Combating the Financing of Terrorism (CFT), Sanctions. This role requires a strong understanding of financial transactions, investigative techniques, and applicable laws and regulations. The Investigator will work closely with internal and external stakeholders, including law enforcement agencies, to identify, assess, and mitigate financial crime risks. The role involves conducting detailed investigations, reviewing transaction patterns, writing investigative reports and preparing suspicious activity reports (SARs). The role requires attention to detail, excellent analytical skills and observes the highest degree of confidentiality in the handling of information. The Investigator must thrive in a fast-paced, dynamic environment and demonstrate adaptability in responding to constantly evolving fraud schemes.</div></div><div></div><div>
What you will be doing:</div><ul><li><div>
Collect and analyze customer and financial transactions for potential fraudulent activity, money laundering, terrorist financing to identify patterns of suspicious activity.</div></li><li><div>
Apply critical thinking skills and experience in writing comprehensive investigation analysis to conclude whether or not to file a SAR. Maintain disciplines in consistently following current processes, procedures and policies ensuring compliance with applicable regulatory requirements regarding timely, accurate and thorough investigations are completed.</div></li><li><div>
Use of Bank systems, vendor applications and search engines to validate identities, research individual backgrounds and obtain information on transactional counterparties.</div></li><li><div>
Develop and maintain professional level communication with internal and external parties that recognizes acceptable business protocols.</div></li><li><div>
Interact with federal, state and local law enforcement agencies in receiving and providing critical investigative and case elements that can be used in prosecuting elements of a crime.</div></li><li><div>
Monitor and analyze emerging financial crime threats and trends.</div></li><li><div>
Maintain accurate and up-to-date knowledge of applicable laws and regulations.</div></li><li><div>
Travel required: 0-10%.</div></li></ul><div></div><div>
Who you are:</div><ul><li><div>
Bachelor's degree is preferred.</div></li><li><div>
Minimum 3 years of investigating and reporting financial crimes, particularly fraud is required.</div></li><li><div>
Minimum 2 years of experience using a fraud detection system is preferred.</div></li><li><div>
Investigative and research skills using various systems.</div></li><li><div>
Excellent written and verbal skills.</div></li><li><div>
Completes more complex investigations that are generally non-system generated (e.g., whistleblower, cyber-crime, elder financial abuse, identity theft, and internal, external and victim fraud).</div></li><li><div>
Ability to use multiple systems simultaneously to gather investigative data.</div></li><li><div>
Accurately completes all assigned investigations prior to the assigned and regulatory deadlines.</div></li><li><div>
Portrays strong investigative and analytical skills to identify patterns, trends, and potential red flags in transactions.</div></li><li><div>
Assesses the effectiveness of systems, processes and tools used to monitor risks and identify opportunities for improvement.</div></li><li><div>
Assists in investigating inquiries from peer BSA teams and all front line lines of business.</div></li><li><div>
Reviews customer accounts and analyzes transactions. This may include analyzing customer types, transaction patterns and account activity, and reviewing customer documentation, such as business licenses, articles of incorporation, or tax returns.</div></li><li><div>
Ability to write comprehensive investigative analysis reviews that meets the requirements of the FFIEC&rsquo;s guidelines.</div></li><li><div>
Excellent written and verbal communication skills. Ability to read, analyze, and interpret general business periodicals, professional journals, or governmental regulations.</div></li><li><div>
Ability to calculate figures and amounts, interpret a variety of instructions furnished in written, oral, or schedule form.</div></li><li><div>
Assists with regulatory reporting (i.e., SAR filing and submission, Financial Elder Abuse, Identity Theft, etc.)</div></li><li><div>
Handles sensitive and confidential information with discretion, avoiding conflicts of interest, acting in an unbiased manner, and upholding professional integrity to maintain trust and credibility.</div></li><li><div>
Thorough understanding and remains informed of changes to BSA and OFAC regulations, including suspicious activity red flags. This includes attending training webinars, seminars, conferences and reading industry publications.</div></li><li><div>
Support the Sr. BSA Investigations Manager, Deputy BSA Officer and BSA Officer, as needed.</div></li><li><div>
Maintain a high degree of professionalism and confidentiality.</div></li><li><div>
Adhere to all company policies and procedures.</div></li><li><div>
Perform other duties assigned by management.</div></li></ul><div></div><div><div>
#LI-ML1</div></div><div></div><div>
Pay Range: $72,500.00 - $108,000.00 annually</div><div>
AIP/Bonus: up to 7.5%</div><div></div><div>
Our comprehensive employee benefits program is designed for you to live your best life at work, home, and everywhere in between. Employees working 25 hours or more per week are eligible for health benefits effective the first day of the month following or coinciding with their date of hire.<br>
Benefits package includes[1]:</div><div></div><ul><li><div>
Medical, prescription, dental, and vision coverage for employees and their eligible family members</div></li><li><div>
Employer paid Employee Assistance Program, Life Insurance, AD&amp;D, and Disability benefits</div></li><li><div>
Health Savings Account with employer contribution</div></li><li><div>
Healthcare and Dependent Care Flexible Spending Accounts and Commuter/Parking Benefit</div></li><li><div>
401(k) and Roth 401(k) with company contribution</div></li><li><div>
529 Education Savings plan, Tuition Reimbursement Program and Student Loan Assistance Program</div></li><li><div>
Supplemental Health plans, Voluntary Legal and Identity Theft Services</div></li><li><div>
11 paid holidays, paid Sick days (accrual of one hour for every 30 hours worked), up to 25 paid vacation days, and 16 hours of paid volunteer time throughout the calendar year</div></li><li><div>
Free personal checking and savings account; Discounted rates on primary residence loan with $0 origination fees (restrictions apply)</div></li></ul><div></div><div>
Final compensation package will be determined by the work experience, education, and/or skill level of the applicant along with internal equity and alignment with geographic market data.</div><div></div><ul><li><div>
Mechanics Bank is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, religion, national origin, age, genetic information, veteran status, or on the basis of disability, gender identity, sexual orientation or other bases prohibited by applicable law.</div></li><li><div>
Please view Equal Employment Opportunity Posters provided by OFCCP <div>here</div>.</div></li><li><div>
To learn more about Mechanics Bank&rsquo;s California privacy and security policies, including your right to a Notice At Collection as a California Resident, please visit</div><div><div>
California Privacy Policy for Prospective Employees | Mechanics Bank</div></div></li></ul><div></div><div>
[1] The benefits listed in this job posting reflect the Bank&rsquo;s most reasonable and genuinely expected benefits offered for this position.</div></div>

Sr. Fraud Investigator

CGS Federal (Contact Government Services)

<div>
 Employment Type: Full-Time, Mid-Level
 <br/>
 <br/>
 Department: Litigation Support
 <br/>
 <br/>
 CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.
 <br/>
 <br/>
 CGS brings motivated, highly skilled, and creative people together to solve the government&rsquo;s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities.
 <br/>
 <br/>
 Responsibilities will Include:
 <br/>
 <br/>
 <br/>
 <ul>
  <li>
   Review, sort, and analyze data using computer software programs such as Microsoft Excel
  </li>
  <li>
   Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.)
  </li>
  <li>
   Develop HCF case referrals including, but not limited to:
  </li>
  <li>
   Ensure that HCF referrals meet agency and USAO standards for litigation
  </li>
  <li>
   Analyze data for evidence of fraud, waste and abuse
  </li>
  <li>
   Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence
  </li>
  <li>
   Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings
  </li>
  <li>
   Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc
  </li>
  <li>
   Assist conducting witness interviews and preparing written summaries
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 Qualifications:
 <br/>
 <br/>
 <br/>
 <ul>
  <li>
   Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field
  </li>
  <li>
   Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work
  </li>
  <li>
   Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc
  </li>
  <li>
   Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data)
  </li>
  <li>
   Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy
  </li>
  <li>
   U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
  </li>
  <li>
   Experience and expertise in performing the requisite services in Section 3
  </li>
  <li>
   Must be a US Citizen
  </li>
  <li>
   Must be able to obtain a favorably adjudicated Public Trust Clearance
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 Preferred qualifications:
 <br/>
 <br/>
 <br/>
 <ul>
  <li>
   Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3
  </li>
  <li>
   Relevant experience working with a federal or state legal or law enforcement entity
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 #CJ
 <br/>
 <br/>
 We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
</div>


Healthcare Fraud Investigator

State of New Hampshire

<div><div><p><b>State of New Hampshire Job Posting
</b></p><p></p><p><b>Insurance Department
</b></p><p>Legal Division
</p><p>21 S Fruit Street, Suite 14, Concord, NH 03301<br>
</p><p></p><p><b>SENIOR INSURANCE FRAUD INVESTIGATOR
</b></p><p>Position #9U545<br>
<br>
</p><p>$69,255.00/annually - $96,385.00/annually<br>
<br>
</p><p></p><br>
<p><b>*See total compensation information at the bottom of announcement.<br>
</b></p></div><p></p><br>
<p>The State of New Hampshire, Insurance Department, Legal Division has a full-time vacancy for Senior Insurance Fraud Director.<br>
</p><p></p><br>
<p><b>SUMMARY:
</b></p>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.<br>
<p></p><br>
<p><b>YOUR EXPERIENCE COUNTS </b>: 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.<br>
<br>
</p><p></p><br>
<p><b>PREFERRED QUALIFICATIONS:
</b></p><p>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.
</p><p></p><p>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.
</p><p></p><p>License/Certification: Must possess a valid driver's license and/or have access to transportation for use in statewide travel.
</p><p></p><p>Other Requirements: None
</p><p></p><p>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.<br>
</p><p></p><br>
<p><b>RESPONSIBILITIES:
</b></p><p>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.<br>
</p><p></p><br>
<p>Examine and analyze complex insurance company, provider and Agent/Producer records, claims information and financial statements for potential fraud.<br>
</p><p></p><br>
<p>Complete field canvasses and utilize databases to locate witnesses and suspects developed throughout investigations in order to conduct interviews and/or interrogations.<br>
</p><p></p><br>
<p>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.<br>
</p><p></p><br>
<p>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.<br>
</p><p></p><br>
<p>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.<br>
</p><p></p><br>
<p>Provide testimony in both federal and state courts as an expert witness to summarize and give opinion on evidence and information.<br>
</p><p></p><br>
<p>Draft search warrant affidavits for court approval; collaborate with law enforcement agencies and assist in the execution of the search warrants.<br>
</p><p></p><br>
<p>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.<br>
</p><p></p><br>
<p>Develop and present training programs to insurance carriers and law enforcement agencies, as well as the general public to help address fraud awareness.<br>
</p><p></p><br>
<p><b>DISCLAIMERS </b>:
</p><p>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.
</p><p></p><p>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.<br>
</p><p></p><br>
<p>For position-related questions, please contact Roni Karnis, Esq., General Counsel, at Roni.M.Karnis@ins.nh.gov.
</p><p></p><p>For application-related questions, please contact Katrina Gagne, Human Resources Technician, at Katrina.L.Gagne@ins.nh.gov.<br>
</p><p></p><br>
<p><b>*TOTAL COMPENSATION INFORMATION
</b></p><p>The State of NH total compensation package features an outstanding set of employee benefits, including:
</p><p>HMO or POS Medical and Prescription Drug Benefits:
</p><p></p><p>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.
</p><p><b>See this link for details on State-paid health benefits:
</b></p><p>https://www.das.nh.gov/hr/benefits.aspx<br>
<br>
</p><p>Value of State's share of Employee's Retirement: 12.87% of pay<br>
<br>
</p><p><b>Other Benefits:
</b></p><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><p></p><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><p>Total Compensation Statement Worksheet:
</p><p>https://www.das.nh.gov/jobsearch/compensation-calculator.aspx<br>
<br>
</p><p><b>Want the specifics? Explore the Benefits of State Employment on our website:
</b></p><p>https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf<br>
<br>
</p><p>https://www.das.nh.gov/hr/index.aspx<br>
<br>
</p><p>EOE
</p><p></p><p>TDD Access: Relay NH 1-800-735-2964</p></div>

SENIOR INSURANCE FRAUD INVESTIGATOR

Allied Universal Compliance and Investigations

<div><p>Major Case Unit Investigator</p><h2 class="jobSectionHeader"><b>
Overview</b></h2><p>
Company Overview:
</p><p>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.</p><h2 class="jobSectionHeader"><b>
Job Description</b></h2><p>
Allied Universal&reg; is hiring a <b>Major Case Unit Investigator.</b> 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.</p><br>
<p></p>
<p></p><p><b>RESPONSIBILITIES:</b>
</p><ul><li>Use <b>specialized services</b> 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><br>
<p></p>
<p><b>QUALIFICATIONS (MUST HAVE):</b>
</p><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><p><b>
PREFERRED QUALIFICATIONS (NICE TO HAVE):</b>
</p><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><p><b>
BENEFITS:</b>
</p><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"><b>
Closing</b></h2><p>
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
</p><p>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.</p><h2 class="jobSectionHeader"><b>
Requisition ID</b></h2><br>
2026-1536779</div>

Major Case Unit Investigator

<div><p>Major Case Unit Investigator</p><h2 class="jobSectionHeader"><b>
Overview</b></h2><p>
Company Overview:
</p><p>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.</p><h2 class="jobSectionHeader"><b>
Job Description</b></h2><p>
Allied Universal&reg; is hiring a <b>Major Case Unit Investigator.</b> 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.</p><p><br>
</p><p><b>hourly rate of pay $35 - $40 / hr</b></p><br>
<p></p><p><b>RESPONSIBILITIES:</b>
</p><ul><li>Use <b>specialized services</b> 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><p><b>
QUALIFICATIONS (MUST HAVE):</b>
</p><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><p><b>
PREFERRED QUALIFICATIONS (NICE TO HAVE):</b>
</p><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><p><b>
BENEFITS:</b>
</p><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"><b>
Closing</b></h2><p>
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
</p><p>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.</p><p><br>
</p><h2 class="jobSectionHeader"><b>Requisition ID</b></h2><br>
2026-1536795</div>

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