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Senior Fraud Claims Jobs in Indiana (NOW HIRING)

Sr. TLE Auto Appraiser

Goshen, IN · On-site +1

$63K - $121K/yr

The Opportunity As a Sr. TLE Auto Appraiser, within defined guidelines and framework, will be ... Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for ...

Sr. TLE Auto Appraiser

South Bend, IN · On-site +1

$63K - $121K/yr

The Opportunity As a Sr. TLE Auto Appraiser, within defined guidelines and framework, will be ... Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for ...

$89K - $105K/yr

Review underwriting fraud referrals for appropriateness and assist management with book of business ... Review contestable claims for potential misrepresentation during underwriting. * Maintain good ...

... senior management to ensure awareness and high performance related to matters of fraud and loss ... small claims courts, or other fraud or loss related legal matters. Coordinates with various ...

... senior management to ensure awareness and high performance related to matters of fraud and loss ... small claims courts, or other fraud or loss related legal matters. Coordinates with various ...

Senior Fraud Claims information

What does a senior fraud claims specialist do?

A Senior Fraud Claims specialist investigates and resolves complex fraud claims related to financial transactions, such as unauthorized charges or identity theft. They analyze account activity, gather evidence, interview involved parties, and determine the validity of claims. In addition, they may develop strategies to prevent future fraud and provide guidance to junior team members. This role requires a strong understanding of financial regulations, attention to detail, and effective communication skills.

What are the key skills and qualifications needed to thrive as a senior fraud claims specialist?

To excel as a Senior Fraud Claims Specialist, you need strong analytical skills, attention to detail, and experience in fraud detection or claims investigation, often supported by a relevant degree or industry certifications. Familiarity with case management systems, fraud detection software, and data analysis tools is typically required. Excellent communication, problem-solving abilities, and ethical judgment are vital soft skills for building trust and resolving complex cases. These competencies are essential for accurately identifying fraudulent activity, minimizing financial losses, and maintaining organizational integrity.

What are some common challenges faced by senior fraud claims professionals, and how can they effectively overcome them?

Senior Fraud Claims professionals often encounter challenges such as managing high caseloads, keeping up with evolving fraud tactics, and navigating complex regulatory requirements. To overcome these challenges, it's important to stay updated on fraud trends through ongoing training and industry resources, leverage advanced analytical tools, and collaborate closely with cross-functional teams like legal, compliance, and IT. Effective communication and time management skills are also crucial for balancing multiple investigations and meeting tight deadlines.

What is the difference between Senior Fraud Claims vs Fraud Claims Adjuster?

AspectSenior Fraud ClaimsFraud Claims Adjuster
Required CredentialsBachelor's degree, industry certifications (e.g., AIC, CPCU), experience in fraud investigationBachelor's degree, insurance licenses, basic fraud detection knowledge
Work EnvironmentCorporate offices, insurance companies, specialized fraud unitsInsurance companies, claims departments, field or office settings
Employer & Industry UsageUsed in insurance firms handling complex fraud casesCommon in insurance claims processing, including fraud detection
Search & Comparison IntentUnderstanding senior roles in fraud claimsEntry to mid-level fraud claims roles

Senior Fraud Claims professionals typically handle complex fraud investigations, require advanced certifications, and have more experience. Fraud Claims Adjusters focus on processing claims, detecting fraud at a basic to intermediate level, and usually have less experience. The senior role involves leadership and strategic oversight, while the adjuster role is more operational.

What qualifications do I need to work in senior fraud claims?

Senior fraud claims professionals typically need a bachelor's degree in finance, accounting, or a related field, along with several years of experience in fraud investigation or claims processing. Strong analytical skills, knowledge of fraud detection tools, and certifications such as Certified Fraud Examiner (CFE) can enhance qualifications for this role.

What are the most commonly searched types of Fraud Claims jobs in Indiana?

The most popular types of Fraud Claims jobs in Indiana are:

What cities in Indiana are hiring for Senior Fraud Claims jobs?

Cities in Indiana with the most Senior Fraud Claims job openings:

Complex Claims Consultant - EPL, Private & NFP D&O

Cna

Indianapolis, IN

$17 - $23/hr

Full-time

Re-posted 2 days ago


Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

CNA is one of the premier providers of professional liability insurance. CNA Financial Lines has an opening for a Complex Claims Consultant handling Employment Practice Liability, Private and NFP D&O claims. This individual will work with insureds, attorneys and brokers regarding the handling and/or disposition of mid to high severity claims.
This individual will investigate claims, coordinate discovery, and team with defense counsel on litigation strategy. This individual will be able to utilize claims policies and guidelines, review coverage, determine liability and damages, set financial reserves, secure information to negotiate and settle claims, and present claims to leadership, as needed. Critical to success in this role is the ability to be highly organized, independently motivated and responsive/communicative.
CNA offers a hybrid work environment in one of the following locations: Chicago, Glastonbury, Lake Mary, Wyomissing, NYC area preferred, but candidates near any CNA location will be considered.

JOB DESCRIPTION:

Essential Duties & Responsibilities

Performs a combination of duties in accordance with departmental guidelines:

  • Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.

  • Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.

  • Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.

  • Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.

  • Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.

  • Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.

  • Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.

  • Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.

  • Keeps senior leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management.

  • Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.

  • Mentors, guides, develops and delivers training to less experienced Claim Professionals.

May perform additional duties as assigned.

Reporting Relationship

  • Typically Director or above


Skills, Knowledge & Abilities

  • Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.

  • Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.

  • Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.

  • Strong work ethic, with demonstrated time management and organizational skills.

  • Ability to work in a fast-paced environment at high levels of productivity.

  • Demonstrated ability to negotiate complex settlements.

  • Experience interpreting complex specialty insurance policies and coverage.

  • Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.

  • Knowledge of Microsoft Office Suite and ability to learn business-related software.

  • Demonstrated ability to value diverse opinions and ideas.

Education & Experience

  • Bachelor's Degree or equivalent experience; JD preferred.

  • Typically a minimum of five to seven years of relevant experience, preferably in claim handling

#LI-CP1

#LI-Hybrid

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.


CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitourcareers page.


CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com