Solid reputation, passionate people and endless opportunities.
That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
Provides specialized investigations support in at least one of the following areas of expertise: Pre-Employment, Vendor Management, Data Analysis or Fraud Coordination
PRIMARY DUTIES AND RESPONSIBILITIES:
Prepares and submits investigative report covering all phases of the investigation in each case for approval
Interprets and communicates technical information to others.
Evidence recognition; determines its value to specific claim, evidence collection and interpretation. Requires clear understanding of rules of evidence.
Conducts investigations with a focus on thoroughness, quality, and attention to detail, timeliness and cost control.
Trains claim staff.
Applies knowledge about all applicable statutes: local, state and federal to investigations to ensure that duties and assignments are carried out within the requirements of applicable law and local office expectations.
Handles information that is considered personal and confidential with a high degree of integrity
Occasional overnight travel (up to fifteen nights per year).
Receives investigative requests from Claim Reps. Determines nature and scope of surveillance investigations.
Determines investigative action plan considering the most cost-effective method for investigations that can be handled via computer and phone or by a vendor (private investigator) for surveillance.
Assigns/approves cases to vendors as appropriate. Approves vendor time. Review vendors' investigative reports and authorizes payments.
Conducts computer and telephone investigations; develops background information. Gathers and maintains evidence. Completes investigative reports to Claim Rep. Testifies if necessary.
Maintains case records.
Assists investigators as needed.
Analyzes data in electronic detection systems to identify patterns. Cross-references through data systems.
Pro-actively researches databases to produce management information aids in assuring that resources are being employed in the most cost - effective manner.
Refers cases to SIU investigators and maintains statistics.
Claim File Reviews:
Conducts file reviews (new notices and existing files) to refer red flag potential fraud files to the SIU.
Conducts inside investigations to detect fraud including taking statements and interviews, database research and document gathering.
EDUCATION/COURSE OF STUDY:
Minimum 2-year college degree or equivalent law enforcement or claim experience.
Basic working level knowledge of insurance and claim operations, commercial, personal, and workers compensation insurance products and litigation management.
Claim, legal or law enforcement background
Advanced verbal and written communication skills.
Computer literate; database and Internet proficient; good typing skills
Analytical skills and ability to make deductions; logical and sequential thinker
Knowledge of available resources (internal and external) to assist in investigations, initiative and innovation on finding what is needed.
High level of organizational skills.
Critical Success Factors:
Productivity (referral rate and/or volume)
Customer Service and Timeliness of Investigation (close rate and average duration of investigation)
Expense Management (cost control, return on investment and/or billing)
Quality of Investigation (efficiency rate and/or QA score)
Travelers is an equal opportunity employer. We actively promote a drug-free workplace.
Job Category : Claim
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