Senior Internal Investigation Unit Investigator (Hybrid or Remote)
About The Position
Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to life alongside a passionate community. Feel empowered to learn and grow while being valued for who you are. At Intact, we commit to supporting you in reaching your goals with tools, opportunities, and flexibility. It’s our promise to you. Who we are At Intact Insurance Specialty Solutions, we are experts at what we do in protecting what makes businesses unique. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that’s aligned to our targeted customer groups. Intact’s Global Specialty Lines business spans across more than 20 verticals in four distinct markets: U.S., Canada, UK and Europe. The following opportunity is for our U.S. team. The opportunity We currently have an opportunity for a Senior Internal Investigation Unit Investigator to join our Claim team located in our Denver, CO office on a hybrid schedule or remotely nationwide. As a Senior Internal Investigation Unit Investigator, your work will be highly confidential to help protect the assets and reputation of Intact Insurance. This position analyzes data and processes, as well as conducts internal investigations of moderate to high levels of complexity for potential fraud or misappropriation. You will work closely with various team members in a strong collaborative and confidential environment.
Requirements
- Bachelor's degree or equivalent experience required.
- 5-7 years of relevant experience.
- Proven experience in conducting investigations.
Nice To Haves
- Experience with multi-line Commercial claims handling preferred.
Responsibilities
- Review cases identified by Scan and Extractions to clear false positives and flag potential fraud cases.
- Analyze all payments on a claim to determine if there is a risk of internal fraud by examining supporting documents such as invoices, receipts, call recordings, and approval records.
- Monitor and analyze employee behavior over time to identify deviations from standard processes and potential fraud patterns.
- Cross-check data to identify discrepancies, overpayments, duplicate payments, or payments to unapproved vendors.
- Identify and flag coaching issues or overpayments to the business that are not related to internal fraud.
- Document coaching issues or overpayments clearly, providing evidence and constructive feedback to the Unit Claim Manager (UCM) or relevant teams.
- Raise identified gaps or issues to the claim consultant or forensic expert and contribute to the development of solutions.
- Gather and review all relevant data from internal systems, such as transaction logs, claim files, payment records, and employee activity logs.
- Compare multiple claims to identify commonalities, patterns, or discrepancies that may indicate fraudulent activity.
- Conduct detailed document reviews to identify inconsistencies, alterations, or signs of forgery.
- Perform open-source research to gather additional information related to the case and validate the information obtained.
- Retrieve, listen to, and transcribe key parts of recorded calls related to the case to identify discrepancies or red flags.
- Participate in IIU projects aimed at improving workflows and processes.
- Collaborate with other departments to gain insights into their claim handling processes and share best practices.
- Participate in the onboarding of new hires and complete assigned monthly training to stay updated on processes and regulations.
Benefits
- Comprehensive medical, dental and vision insurance with no waiting period
- Competitive paid time off programs
- 401(k) savings and annual contributions of up to 12% of annual salary
- Mental health support programs, life and disability insurance, paid parental leave and a variety of additional voluntary benefits
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
1,001-5,000 employees
