Part Time Insurance Fraud Investigator Jobs (NOW HIRING)

Stateof New Hampshire Job Posting
Insurance Department
Legal Division, Fraud Unit
21 S. Fruit Street, Suite 14, Concord, NH 03301
SENIOR FRAUD EXAMINATION SPECIALIST
Position#TMPPT6594
$37.22/hour - $51.07/hour
The State of New Hampshire Insurance Department, Legal Division, Fraud Unit has a part-time vacancy for Senior Fraud Examination Specialist.
SUMMARY: Reporting directly to the Fraud Director, the part-time Senior Fraud Examination Specialist conducts fraud examinations of Department licensees and related parties for suspected insurance-related criminal violations. Additionally, this position assists the Fraud Director in evaluating, developing, and implementing training for all fraud employees.
YOUR EXPERIENCE COUNTS: Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education.
MINIMUM QUALIFICATIONS:
Education/Experience: Bachelor's degree and 7 years of experience OR equivalent combination of 11 years of education and experience after completion of high school. Education and experience must be in accounting, auditing, business administration, insurance management, insurance regulation, or law enforcement with at least 2 years in insurance company examinations, insurance market conduct examinations, insurance fraud examinations and/or insurance fraud investigative work, insurance department rate, insurance policy, insurance contract or consumer protection regulation, insurance underwriting, insurance loss adjustment or a related field.
License/Certification: Valid driver's license or access to transportation
Other Requirements: Must be able to spend periods of time out-of-state and travel throughout the day
Trainee Option: Not applicable
PREFERRED QUALIFICATIONS:
1. Designation as a Certified Insurance Fraud Investigator or Certified Fraud Examiner
2. Thorough knowledge of the insurance laws and regulations of the State of New Hampshire
3. Thorough knowledge of accounting and market conduct principles and practices as used in the business of insurance.
4. Working knowledge of office methods, procedures and equipment
5. Ability to establish and maintain an effective working relationship with other employees, insurance company officials, other US and international regulators and the public
6. Ability to develop administrative and statistical reports with evidence and recommendations
AFTER-HIRE REQUIREMENTS: None
CAREER ADVANCEMENT OPPORTUNITIES:
In-Band Advancement Available: ☐ Yes ☒ No
Criteria: None
Broad Group Level Advancement Available: ☐ Yes ☒ No
Criteria: None
DETAILED TASKS (AGENCY/POSITION-SPECIFIC):
Teaches and provides on-the-job training to trainees, staff and other examiners to develop their knowledge of the principles of insurance, insurance company operations, analysis, investigations, financial analysis and examination skills.
Conducts routine and highly complex fraud examinations of Department licensees and related parties for suspected insurance fraud, as assigned.
Assigns tasks and reviews work product of other examiners or investigators assisting in the examination or investigation of insurance fraud by insurance companies, insurance licensees, medical providers, billing companies, extended warranty companies/contractors, uninsured businesses, and others. Prepares reports for review by General Counsel and participates in redrafting reports as needed.
Provides technical expertise in the examination or investigation which requires knowledge in the areas of compliance with New Hampshire criminal and insurance statutes, department regulations, electronic data processing, internal controls, rating, underwriting, claims review, sales practices, marketing, advertising, provider billing practices, medical coding, fiduciary responsibilities and other areas of examination as needed to insure the integrity and quality of the examination or investigation.
Prepares examination reports or other required reports to document findings, recommendations and conclusions of the examination or investigation, with appropriate references that cite violations of insurance and/or criminal laws, and insurance regulations and bulletins.
Testifies at hearings and trials conducted by the insurance department, the Fraud Attorney or other prosecutor to present, explain and defend findings and recommendations. Participates in preparing enforcement and regulatory actions as needed.
Serves as a liaison between the insurance department and senior company management, chief executive officer and chief legal counsel about procedures that must be adopted to comply with New Hampshire Insurance Department policy and/or regulations, to correct examination or investigative findings and to satisfy recommendations.
Functions so that the examination or investigation is conducted in a fair and professional manner, observes professional standards such as maintenance of independence, professional judgment and discretion, to respect the confidentiality and proprietary aspects of the information received and developed during the course of the examination or investigation.
DISCLAIMERS:
The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that job title.
When applicable, the work of an employee in trainee status in this position shall be overseen by a fully qualified individual. An employee in trainee status shall meet the minimum qualifications within the period of time specified on the SJD, not to exceed one year of being hired into this position.
For position-related questions, please contact Roni Karnis, Esq., General Counsel, at Roni.M.Karnis@ins.nh.gov.
For application-related questions, please contact Katrina Gagne, Human Resources Technician, at ins-careers@ins.nh.gov.
EOE
TDD Access: Relay NH1-800-735-2964