Job Description

Responsibilities:

• Acts as Lead Investigator on assigned highly confidential investigations. Investigations can involve the following areas: fraudulent vendors, improper system access, employee expenses, insurance fraud, check fraud, kickbacks, conflicts of interest, corporate credit card abuse, corporate sabotage, sales improprieties, theft of corporate resources, inappropriate use of email and/or internet, altering business records and others.
• Uses and provides subject matter expertise related to electronic tools used within the department to search for and investigate fraud and allegations of fraud. These tools may include software retrieval packages, electronic databases, search engines, and data manipulation software.
• Directs and monitors progress on assigned multiple concurrent investigations.
• Ensures all investigative work, which may include work completed by others, is complete, accurate, professional, legally supported, and fully documented.
• Prepares detailed reports for presentation to company management and to law enforcement entities when fraudulent activity is identified.
• Participates in and may take a lead role monitoring the Proactive Detection Tools. Identifies high risk areas to be monitored.
• Ensures quarterly data reviews addressing fraud risk areas.
• Evaluates results and prepares quarterly reports for LMI Management.
• Notifies management of any control weaknesses identified and offers solutions to mitigate the risks.
• Assists in triaging investigative requests. Uses all available sources to determine the validity of any allegations received.
• Ensures compliance to standards and regulations. May conduct formal interviews of subjects. Ensures all company and legal procedures are followed during the interview process.
• Assists with special requests received by senior or executive management.
• Coordinates the collection of data for law enforcement and internal management requests.
• Leads complex continuous improvement efforts by providing feedback on investigative process and tool changes that will result in a better product being delivered.
• Participates in developing or enhancing fraud awareness and training programs.

• Bachelor`s Degree in a Business or Criminal Justice field, or equivalent training, is required.
• 3- 5 years related work experience in an investigation capacity required.
• Related claims handling experience is preferred.
• Interview and interrogation skills required.
• Excellent written and oral communication skills required.
• Ability to perform in an automated audit environment.
• Certified Fraud Examiner designation is preferred.
• Travel is a requirement. Candidate must be available to travel with minimal notice.