Fraud Investigator Job Description

Finding qualified, reliable individuals to join your staff is an essential step in growing your business. We’re here to make the hiring process as easy as possible for you. In this guide, we’ll cover all of the following:


WHAT TO INCLUDE IN A JOB DESCRIPTION

A good job description should include a company overview and job overview, as well as an explanation of the associated responsibilities, skills & qualifications, and work environment. Below are some general guidelines for writing each of these sections effectively.

1. COMPANY OVERVIEW


Providing an accurate, concise description of your business is a great way to attract the right employees. Think of this section as an advertisement for your company -- why should prospective employees want to join your team?

Some useful things to include here are:

  • Core company values
  • Mission statement
  • Brief history of your organization
  • Anticipated growth
  • Business goals

 

2. JOB OVERVIEW


In a few sentences, describe the purpose, importance, and fundamental qualities of the position being offered. No need to be too specific or comprehensive here -- the idea is to provide a zoomed-out image of the role the applicant would be filling in your company.

3. RESPONSIBILITIES


This is where you’ll outline the specific day-to-day responsibilities of the job. Bullet-point format is typically the most practical way to present this information.

4. NECESSARY SKILLS & QUALIFICATIONS


List in bulleted format the skills & qualifications that are absolutely essential to this position. Consider as many specific conditions of the job as possible in order to create a complete list of qualifications an applicant must have in order to succeed.

5. PREFERRED SKILLS & QUALIFICATIONS


List in bulleted format the skills & qualifications that are not essential, but would make an applicant more eligible for the position being offered.

6. WORK ENVIRONMENT


Describe the environment in which the applicant would be spending most of their time. In this description, include information about:

  • Company culture
  • Pace of work
  • Amount of collaborative vs. independent activity
  • Who the employee will report to (or vice versa)

Fraud Investigator Job Description

Below is our fraud investigator job description. You can post it as-is to an online job board like ZipRecruiter, or download and customize it to match the unique aspects of your business. Keep in mind that adding a custom company overview and description of the work environment (outlined above) will help you draw in the right applicants.

Fraud Investigator Job Description

Job Overview:

As one of the leading insurance companies in the United States, we take pride in handling claims swiftly and efficiently. Insurance fraud doesn’t just affect our bottom line—those costs trickle down to our customers. In an effort to alleviate that pressure, we are expanding our fraud department. We seek a talented and experienced fraud investigator to join our team on a full-time basis. In this position, you will be responsible for identifying and handling suspicious insurance claims. You will regularly draft professional reports based on your findings, offering consultation and strategic direction regarding how to reduce these risks in the future. Our ideal candidate possesses the skills and the drive to help lead our organization toward future growth.

Responsibilities:

  • Conduct thorough, unbiased investigations into potential fraud, waste, or abuse cases
  • Review and research evidence and documents to analyze the overall claim pattern, synthesizing data into a professional report that includes recommendations based on your findings
  • Coordinate, assign, and oversee field assignments to collect relevant information and evidence
  • Collaborate with our legal team and law enforcement to provide deposition strategies
  • Manage an extensive caseload, with sensitivity to time and confidentiality
  • Draft restitution proposals and prosecution packages

Necessary Skills & Qualifications:

  • Bachelor’s degree in insurance studies, criminal justice, risk management or related field
  • One or more years of proven work experience in a related field
  • Must be able to pass a background investigation, polygraph examination, and urinalysis drug test
  • Excellent interpersonal and communication skills with an ability to interact with law enforcement, upper management, and clients
  • Ability to think strategically with attention to detail and strong investigative skills
  • Ability to work independently with minimum supervision
  • Strong organizational skills and an ability to prioritize as you manage a high case volume
  • Extensive knowledge of insurance regulations, procedures, and investigation methods
  • Strong verbal and written communication skills, including an ability to conduct interviews
  • Hands-on experience with information system software

Preferred Skills & Qualifications:

  • Certificate of insurance fraud investigator preferred
  • Ability to travel several times a year
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3 STEPS TO TAKE WHEN HIRING EMPLOYEES

ENSURE LEGAL COMPLIANCE


Hiring employees can be an intimidating and time-consuming process, but it doesn’t have to be. We’ve created a hiring compliance checklist to help you get over the legal hurdles with ease. From obtaining an Employer Identification Number (EIN) to confirming work eligibility, our guide covers everything you need to know.

SET UP PAYROLL


Even if your business only has a few employees, setting up a payroll service can save you time for running your business and also ensure that your company is compliant with important federal requirements, such as employee withholding.

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We recommend Gusto, a user-friendly payroll platform for small businesses. Try out their services and get one month free.

Sign up now

ACQUIRE WORKERS' COMP INSURANCE


Workers’ compensation insurance provides financial and legal protection for your business and its employees.

Whether or not you need workers’ comp insurance for your company depends on the nature of the job, the employer-employee relationship, and the unique regulations of your state.

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Find out how much the right insurance will cost you.

GET A QUOTE