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Manager, Special Investigations

WCF Insurance
Sandy, UT
  • Expired: August 09, 2022. Applications are no longer accepted.

Position

The Claims Services department has an immediate opening for someone who can demonstrate the WCF values to join their team as a full-time Manager, Special Investigations. This posting is open to internal and external candidates.


Responsibilities

  • Responsible for investigating all forms of commercial insurance fraud applicable to WCF Insurance, from application to audit: claimant, policyholder, producer, underwriting, premium, provider, etc.
  • Provide leadership, administrative, investigative, and educational services to all WCF departments, policyholders, state law enforcement and government agencies, and criminal prosecutors.
  • Manage a team of SIU investigators and administrative staff; determine the appropriate workload that is in the best interests of WCF, mentor staff and perform regular evaluations, and regularly review SIU files to ensure quality standards.
  • Oversee investigation requests from internal and external sources, ensuring prompt attention and resolution.
  • Responsible for evaluating, selecting, and ensuring quality and cost containment for vendors including surveillance contractors, private investigation firms, and any other vendors that might be used by the SIU department for Investigation of property and casualty insurance fraud.
  • Maintain a documented system of SIU policies, systems, procedures and workflows to ensure smooth operations.
  • Coordinate efforts with local and state law enforcement agencies, criminal prosecutorial bodies and other governmental agencies in identifying, investigating and deterring Insurance fraud.
  • Prepare annual budget for the special investigations unit.
  • Provide feedback to Management on process and system improvement initiatives for the department
  • Complete annual SIU Compliance Report and ensure ongoing training of all internal anti-fraud personnel.
  • Ensure compliance with state departments of insurance regarding SIU protocols, standards, and reporting.
  • Represent WCF's interests in monetary restitution and plea bargain negotiations in criminal actions.
  • Attend SIU training and SIU organization meetings and impart the knowledge learned to company personnel.
  • Evaluate fraud referrals for validity and merit and assign on a priority basis to fraud investigators.
  • Present criminal case matters to external administrative bodies.

Qualifications

The most qualified applicants will have:

  • At least seven years' experience in property and casualty insurance fraud investigation, law enforcement, or criminal investigation.
  • Must have clear understanding of insurance industry practices, standards, and terminology.
  • Bachelor's degree in a related field or relatable work experience; master's degree preferred.
  • Certified Fraud Examiner (CFE) or Certified Insurance Fraud Investigator (CIFI) designation preferred.
  • Must have a solid foundation of personal organization, sound decision making, analytical ability, strong managerial, interpersonal and customer service skills.
  • Knowledge of criminal investigative interview methods and the ability to solicit necessary facts from people in a professional and skilled manner.


An internal candidate should have six months in their current position, acceptable job performance, and must notify their current supervisor that they've applied for the position.



WCF INSURANCE DE&I MISSION

Promote and embrace a diverse, inclusive, equitable, and safe workplace.


WCF INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER

WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.

Employment Type: FULL_TIME

WCF Insurance

Address

Sandy, UT
84070 USA

Industry

Legal

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