Job Description

SIU Fraud Analyst - Careers At Veracity Research Co LLC Share with friends or Subscribe! Back To Openings

SIU Fraud Analyst

Department: FACT - CA SAG Location: Phoenix, AZ
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VRC Investigations is currently expanding our SIU Fraud Abatement and Compliance Team (FACT). Veracity Research Company Investigations (VRC), is one of the nation’s leading and most experienced investigation companies. For 29 years, we have continued to commit ourselves to the utmost degree of integrity and professionalism specializing in all aspects of insurance defense investigations to include; claims investigations, SIU investigations and Vendor Management Programs. We receive and successfully complete thousands of assignments each year for a broad spectrum of clients including Insurance Companies, Third Party Administrators, Self-Insured Organizations, Attorneys, Federal and State Government Agencies, and Municipalities. Our highly trained, investigative staff is dedicated to providing our clients with the service they deserve and the quality they expect. In providing reliable, superior and honest investigations, VRC has taken the lead in the industry by exceeding the expectations of our customers and investigative partners.

VRC is seeking qualified SIU Insurance Fraud Analyst with a passion for research, writing, investigating and critical thinking. We provide initial and on-going training, opportunity for growth, a positive work environment and a versatile and interesting caseload. The right candidate is skilled and demonstrates a passion for research and analysis of medical reports, surveillance, depositions, underwriting and policy documents, claims and other investigative evidence. The SIU Insurance Fraud Analyst’s findings are compiled into a professional report with recommendations to benefit our clients. The SIU Insurance Fraud Analyst will be trained to provide consultation and strategic direction on suspicious or problematic nationwide insurance claims (workers’ compensation, general liability, property & casualty, auto), compliance, as well as coordinate with law enforcement regarding criminal investigations through to prosecutions. These positions are full time, non-exempt, based in our corporate office in Sacramento, CA or home-based remote positions.

The successful candidate will have related experience in one or more of the following areas:

• 2+ years experience in a related field (i.e. workers’ compensation, risk management, insurance industry, medical field, nurse case management, investigations, law enforcement, legal, fraud, financial crime, etc.)
• Bachelor’s/Master’s Degree in Criminal Justice or related field highly preferred

Core Duties & Responsibilities:

• Review and analyze insurance claims from insurance carriers, third party administrators and self-insureds located in California and nationwide (Workers’ Compensation, General Liability, Property & Casualty, Auto)
• The Analyst will review and research evidence including surveillance film, investigative reports, social networking, depositions, statements, CPT codes, billing discrepancies, shell companies, etc. wherein they will analyze the overall pattern of the claim and synthesize the data into a professional report with recommendations for the client
• The Analyst will make sure all insurance carrier clients are in compliance with fraud reporting requirements in California and nationwide
• Prepare and coordinate field assignments to obtain relevant evidence and information while meeting objectives and providing recommendations
• Coordinate with defense attorneys to provide deposition strategies
• Prepare and package cases for law enforcement. Successfully work with investigators, detectives and prosecutors during criminal investigations, while keeping clients updated
• Successfully manage a large and varied caseload; prioritizing cases effectively and efficiently and achieving positive results Upon hiring, paid formal training is provided at our Texas corporate training academy along with on-the-job training
• Occasional air and ground travel may be required
• Occasional interviews with law enforcement required
• Occasional Workers’ Compensation Appeals Board and Criminal Court testimony required
• Occasional conference calls and possible in-person public speaking (small to medium groups), and give case briefs during internal FACT meetings/as needed
• Completion of mandatory annual continued education courses for licensing purposes

Applicants must meet the following requirements:

• Excellent verbal and written communication skills
• Demonstrated ability to research and investigate, analyze information, develop logical questions and accurately report findings
• Proficiency in Microsoft Office programs (Outlook, Word, Excel, PowerPoint)
• Proficient in basic math skills and excel formulas
• Proficient in basic social media research
• Excellent time management skills
• A strong customer service focus
• Ability to frequently pivot and adapt to change based on client and industry needs
• Willing to travel
• Willing to testify in Workers’ Compensation and Criminal hearings
• Willing to participate in interviews with law enforcement
• Ability to work during business hours and attend virtual internal/company meetings as needed
• A strong desire to learn and work as a team
• Appropriate handling of confidential and sensitive information
• Ability to maintain as an unbiased, neutral third party
• Possess a valid driver’s license and provide MVR
• A Private Investigator license is mandatory in some states
• Must pass a drug test, and pre-employment testing

Benefits:
VRC also offers medical, dental, vision, disability benefits, as well as paid holidays, paid vacation, and a 401K/Profit Sharing retirement plan.

Compensation:
VRC investigators are paid on a bi-weekly basis at an hourly wage $23.00 - $26.00/hr to commensurate with experience.

For more information and to apply online, please visit our web site located at .

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Hourly pay, Weekly pay, Holiday work, Full time, Remote job, Work at office, Training, Online, Private, Field, Work from home, Training courses, Paid training, Travel,

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