Special Investigator - Life Insurance

Role Description :

• Able to execute Fraud Investigation Case consisting of 4 types of investigations : Claims Investigation / Life Annuity Investigation, Financial Crime / Fraud, Medicare Supplement Claims, Overall Life company Product Fraud.
• Complete Regulatory Reporting Requirements.
• Develop, maintain, monitor Life company Fraud trends and strategies.
• Manage Fraud operational losses within the approved risk appetite, perform fraud detection.
• Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
• Investigation, resolution, and recovery activities.
• Participation in risk assessments and audits of Fraud at Life Company.
• Contestable claims letters drafted by investigator are required to be reviewed by Business Process Owner (BPO) or Senior until proficient. Professional writing skill set required with clear, concise and effective writing.
• Understanding of validation process which is applied by investigators at the time of case activation, case closure and throughout the life cycle of the investigation to ensure that USAA fulfills and supports the investigative process.
• Validation will be conducted to verify that the contents of the case are accurate and properly reflect the investigative findings to include (but not limited to) : case activation, linking and unlinking of case entities, routed alerts, suspicious dollar, losses, regulatory reporting and case closure.

Essential Skills :

Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.