Major Case Specialist
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As a major case specialist, you’ll identify, investigate, and resolve potentially fraudulent claims with organized insurance fraud activity. You’ll focus on claims with pre-meditated, collusive activity by multiple parties or deliberate fraud by third-party service providers and vendors. In this role, you’ll determine the full scope and network of fraud schemes along with implementing and recommending proactive, risk-mitigating tactics. This is a field position with frequent travel.
Duties & responsibilities (upon completion of training)
- Perform investigative fieldwork and utilize appropriate investigative tools (i.e. databases, informational resources, and public records)
- Set and execute investigative strategies for handling multiple insurance claims including relationships between parties
Qualifications
- A minimum of six years of relevant work experience with three years in claims handling and/or investigation
- {OR} Associate's degree and a minimum of five years of relevant work experience with three years in claims handling and/or investigation.
- {OR} Bachelor's degree or higher and a minimum of three years in claims handling and/or investigation.
- This position requires a valid driver's license and auto insurance.
- This position requires compliance with Progressive's driving standards and/or policies.
Preferred skills
- At least five years of experience handling a variety of complex insurance claims and investigations and either current or prior insurance special investigations experience
- Detecting collusive activity by multiple parties and/or deliberate fraud by third party service providers and vendors
- Developing and executing investigative action plans to address potential organized fraud.
- Serving as a subject matter expert in providing fraud awareness, guidance, and mentorship to Claims personnel.
- Networking with industry personnel, law enforcement, legal counsel, Departments of Insurance, and the National Insurance Crime Bureau
Schedule: Monday - Friday
Compensation
- $95,000-$126,700/year
- Gainshare annual cash incentive payment up to 24% of your eligible earnings based on company performance
Benefits
- 401(k) with dollar-for-dollar company match up to 6%
- Medical, dental & vision, including free preventative care
- Wellness & mental health programs
- Health care flexible spending accounts, health savings accounts, & life insurance
- Paid time off, including volunteer time off
- Paid & unpaid sick leave where applicable, as well as short & long-term disability
- Parental & family leave; military leave & pay
- Diverse, inclusive & welcoming culture with Employee Resource Groups
- Career development & tuition assistance
Equal Opportunity Employer
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