SENIOR INSURANCE FRAUD INVESTIGATOR

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 ‘trainee status’ 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’ 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:

• Dental Plan at minimal cost for employees and their families ($500-$1800 value)

• Flexible Spending healthcare and childcare reimbursement accounts

• State defined benefit retirement plan and Deferred Compensation 457(b) plan

• Work/life balance flexible schedules, paid holidays and generous leave plan

• $50,000 state-paid life insurance plus additional low-cost group life insurance

• Incentive-based Wellness Program (ability to earn up to $500)

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