Senior Special Claims Investigator
| Company | American Financial Group |
|---|---|
| Location | Cincinnati, OH, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- Bachelor’s Degree in Criminal Justice, Risk Management and Insurance, Business Administration, or a related field or equivalent experience.
- Generally, a minimum of 6 years of casualty claim handling experience with some Criminal Investigation or Fraud Detection experience.
- Strong knowledge of Claims investigation laws and regulations.
- Ability to identify and address subtle details that could impact the outcome of an investigation.
- Demonstrated advanced ability to organize and prioritize caseloads, ensuring timely completion of investigations.
- Excellent interpersonal and communication skills to collaborate with appropriate parties to ensure thorough and accurate claims settlements.
- Proven ability to handle confidential information with discretion.
- Excellent analytical skills with the ability to use data to analyze situations, identify problems, and develop effective solutions.
Responsibilities
- Detects and prevents fraudulent claims through meticulous investigation and complex analysis.
- Analyzes and interprets data to identify inconsistencies, potential fraud, and the overall legitimacy of claims.
- Prepares comprehensive reports summarizing investigation findings and recommends claim approval or denial.
- Evaluates claims and may recommend courses of action to management.
- Ensures claims are settled accurately and fairly, minimizing fraudulent activities and protecting the company’s financial interests.
- May present evidence and/or deliver testimony in situations where law enforcement agencies seek prosecution.
- Contributes to the continuous improvement of investigation processes and techniques, enhancing overall efficiency and effectiveness.
- May contribute to the development of program awareness initiatives or facilitate training sessions focused on the detection, deterrence, and prevention of fraudulent activities.
- Performs other duties as assigned.
Preferred Qualifications
- Continuing progress toward and/or the completion of a professional designation preferred, such as Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner, or Private Investigator license from a National Investigation Organization or State Agency.