Claims Special Investigator III

AAA•Bakersfield, CA

About The Position

Claims Special Investigator III This position's primary responsibility is the investigation and disposition of potentially fraudulent claims in any product line sold by the organization. The position also acts as liaison between the organization and industry entities, which include other carriers, law enforcement, District Attorneys, NICB and the Department of Insurance. The position requires a diverse skill set which includes investigating, public speaking, teaching and reporting. The position requires a high degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.

Requirements

Bachelor’s or equivalent combination of education and experience preferred
4-6 Year prior Claims experience required
Moderate computer and line of business technical software skills required.
Advanced application of policy language as applied to coverage, liability, and settlement.
Advanced organization and planning recognition skills required.
Advanced oral and written communication skills required.
Advanced interpersonal skills required.
Advanced interviewing and negotiation skills required.
Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State required.

Responsibilities

Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims.
Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, background search, and research as appropriate.
Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings/recommendations to claims staff.
Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.
Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.
Provide training to claims staff on insurance fraud and industry trends.
Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.