Fraud & Compliance Investigator

Sedgwick

90d

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. The primary purpose of this role is to analyze and investigate reported, alleged, or suspected fraud and compliance matters related to Sedgwick operations, personnel, third-party vendors, and service providers; to identify fraud trends; prepare, document and produce internal reports and criminal referrals to state and federal enforcement agencies and regulatory bodies.

Requirements

• Bachelor’s degree in business or related field required.
• Certified Fraud Examiner (CFE) designation strongly preferred.
• Six (6) years of fraud investigation, compliance, legal, or insurance experience or combination of education and experience preferred.
• Legal knowledge of fraud & compliance laws, claims management, experience with AI, regulatory interpretation and applications, Microsoft 365.
• Strong oral and written communication, presentation skills.
• Strong analytical, interpretive, and organizational skills.
• Ability to work independently and in teams, manage multiple projects and stakeholder engagement and influence.

Responsibilities

• Proactively assists fraud & compliance leadership in the prevention, detection, investigation, and resolution of fraud & compliance matters through analysis and investigation.
• Conducts thorough investigations into fraud and compliance matters, including initial case assessment, planning, evidence collection, stakeholder interviews, and reporting.
• Oversees fraud compliance efforts related to employee dishonesty, vendor fraud, financial fraud schemes against Sedgwick and carrier/clients.
• Oversees regulatory efforts related to AML, FCPA, and Sanctions regulations across the Americas, ensuring alignment with global standards where applicable.
• Collaborates with organizational stakeholders to investigate and resolve fraud, compliance, regulatory, and other significant matters.
• Ensures timely and accurate documentation of investigative findings.
• Testifies in criminal, civil and/or administrative proceedings.
• Maintains liaison relationships with law enforcement and district attorneys.
• Contributes to the root cause analysis on internal and external fraud & compliance events.
• Assists in the development, presentation, and compliance of fraud training for the organization.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees