Senior Special Claims Investigator (Miami/Dade)

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.
 
Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.
 
Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.

It’s one thing to know workers’ comp. It’s another to know people. But knowing both? That creates an altogether different experience.

So, if you’re ready for an altogether different workplace experience, get to know the people who know workers’ comp. Apply today.

Essential Job Functions and Responsibilities

• Conducts specific investigations for claims cases:
  • Investigates all suspect fraud referrals.
  • Secures necessary information (i.e., reports, policies, appraisals, releases, statements, or other documents) to assist in the investigation of claims.
  • Identifies trends and patterns of suspected fraudulent activity.
  • Personally handles field investigations or assigns field work (i.e., surveillance, statements, etc.) to independent investigation firms.
  • Coordinates efforts with law enforcement agencies, state agencies, Claims personnel, and counsel.
• Prepares investigation reports and detailed comprehensive reports.  Evaluates claims and recommends courses of action to management.
• May provide evidence and/or testify in cases where law enforcement agencies pursue prosecution.
• May assist in developing program awareness or conducting training on the detection, deterrence, and prevention of fraud.
• Performs routine searches and prepares standard reporting, utilizing databases and technology that support investigations:
  • Participates in identifying enhancements to improve performance and functionality of technology applications.
  • May participate in testing the application.
• Provides technical advice to lower level positions and other functional areas.
• May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.
• Florida workers compensation knowledge.
• Performs other duties as assigned.
• The person hired for this position will manage the Miami/Dade area.

Must reside in Miami-Dade county area.

Job Requirements

Education: Bachelor’s Degree or equivalent experience.

Field of Study: Law Enforcement, Criminal Justice, Liberal Arts, Business, Computer Science or a related discipline.

Experience: Generally, 6 to 10 years of related experience, including Criminal Investigation or Fraud Detection experience.  Professional designation (i.e., Certified Fraud Examiner, Private Investigator license, etc.) from a recognized National Investigation Organization or State Agency preferred. 

Company:

Salary Range:

Benefits:

Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.

We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.

Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

Salary : $76,800 - $103,200