Investigator II

Company



American Modern Insurance Group



Location



Cincinnati
, United States

The Corporate Special Investigative Unit (CSIU) is primarily responsible for overseeing and managing American Modern's fraud prevention efforts. This includes investigating external cases where there are red flag indicators of fraud, particularly those involving policyholders or claimants arising from claims and policy transactions, The CSIU also implements automated, state-of-the-art fraud detection and monitoring tools, and conducts investigations into internal matters. This team operates within the Legal Department.

Roles & Responsibilities:

• Conduct routine to moderately complex investigations of suspected fraud involving external parties (policyholders, claimants, vendors) with minimal oversight, in collaboration with key stakeholders. Investigate more complex cases with active oversight and support from a Senior Investigator or leadership. Ensure all investigations are completed timely, accurately, and with the highest degree of integrity, confidentiality, and objectivity.
• Utilize public and private records to enhance investigations and prepare clear, concise written reports summarizing investigative findings. Collaborate closely with corporate legal to navigate various fraud statutes and immunity laws.
• Effectively communicate intelligence regarding fraud trends to management and internal business partners.
• Provide annual anti-fraud training to key employees.
• Comply with all applicable laws, company policies, and procedures.
• Collaborate with business units to address control deficiencies, develop remediation plans, and track progress as necessary. Apply lessons learned to other areas that may be affected by similar control failures.
• Maintain a proficient knowledge of AMIG products, systems, and state insurance regulations, with the ability to assess their impact on various lines of business.

Required technical skills:

• Investigative best practices and techniques
• Fraud Prevention techniques and risk assessment
• Utilization of public and private records as well as social media to enhance investigations
• Advanced interview techniques
• Project management
• Proficient with Microsoft Office

Requirements:

• Industry certification/designations
• Bachelor's degree or equivalent work experience
• 5 - 7 years SIU, Claims, and/or Law Enforcement experience
• 4+ years insurance industry experience
• Comprehensive understanding of anti-fraud and investigative best practices and techniques
• Comprehensive understanding of public and private records (ISO, Lexis-Nexis, and Criminal/Civil Records).
• Comprehensive knowledge of P&C Insurance
• Skilled with Microsoft Office Suite
• Possesses proficient knowledge of AMIG products, systems, and processes gained through training and hands-on experience.
• Demonstrates the ability to apply this expertise to conduct thorough investigations of routine to moderately complex internal and external matters.
• Has intermediate proficiency in using data analysis tools for fraud detection. Proven track record of successfully addressing complicated and sometimes inconsistent information to resolve situations effectively.