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Job Status:
Full Time
Work Experience Required:
Up to 2 Years
Hours/Shifts:
Day (First Shift)
Education Required:
BA Degree or BS Degree
Certification Required:
Associate in Claims or CPCU designation preferred or experience related to detection and investigation of fraudulent insurance acts.
Weekends:
Not Required
Authorized to work in US:
Yes
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| Pay and Benefits |
Salary Range:
Unspecified
Benefits:
Life Insurance, Dental Insurance, Disability, 401K, Vision Insurance, Health Insurance
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Special Investigative Unit Manager
Kentucky Farm Bureau
Job Title: Special Investigative Unit Manager
Reports to: Director, Compliance & Auditing Services
Department: Legal
Section: Compliance & Auditing Services
Job Status: Exempt
JOB SUMMARY
The Manager oversees the Special Investigative Unit, including coordination of all suspected fraudulent insurance acts as defined in KRS 304.47-020. This person will also train appropriate personnel to identify possible insurance fraud and compliance issues. Additionally, this person will report to the State Insurance Fraud Unit as required.
ESSENTIAL FUNCTIONS
• Develop and maintain effective Special Investigative Unit.
• Perform investigations on possible fraudulent insurance claims as required as well as investigations on potential employee and agent fraudulent activity.
• Work with Compliance staff in developing effective methods to detect and investigate suspected fraudulent insurance activity.
• Assist in the development and implementation of a corporate anti-fraud strategy.
• Conduct ongoing training for all claims staff and all other personnel in the identification of possible insurance fraud.
• Cooperate with all departments within the company in detection and investigation of possible fraudulent activity.
• Cooperate with outside agencies in the detection, investigation, and prosecution of possible insurance fraud.
• Develop and maintain adequate database to meet any reporting requirements of the Insurance Fraud Unit.
• Maintain superior knowledge of detection and investigation of insurance fraud.
• Regular, predictable attendance.
• This list of essential functions is non exhaustive and may be supplemented as necessary.
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Experience and Education:
OTHER RESPONSIBILITIES
• Maintain close working relationship with Claim staff to ensure their training needs are met regarding fraud detection.
• Develop process flow for communication between Claim staff and SIU investigators to ensure timely handling of investigations.
• Maintain current knowledge of policy contracts and related provisions, court decisions and industry trends affecting the handling of possible insurance fraud.
• Attend training, educational programs and seminars as approved by management to remain current on detection and investigation of insurance fraud.
• Participate in company and industry sponsored educational programs and seminars.
• Develop training materials as needed for proper training of all company personnel in identification of possible insurance fraud.
JOB SPECIFICATIONS
• Physical demands: Normal vision/hearing with or without correction Able to drive a motor vehicle Sitting.
• Mental demands: Analytical reasoning Prolonged concentration Time pressure Public speaking required.
• Environmental factors: Standard office lighting, temperature and noise.
• Equipment: Computer/computer software Telephone/Dictaphone Motor vehicle.
QUALIFICATIONS
• Bachelor's degree required.
• Associate in Claims or CPCU designation preferred or experience related to detection and investigation of fraudulent insurance acts.
• Excellent communication skills – verbal and written.
• Ability to make difficult and timely decisions.
• Knowledge of Kentucky law as it relates to the handling of possible fraudulent insurance claims.
• Ability to read and interpret correspondence, legal documents, and insurance policies.
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