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Please contact President James Koch (james.koch@nationwide.com) to have any SIU job openings posted on this page!


Posted: 07/11/2023
AmTrust Financial Services, Inc.


Investigative Analyst

 

Summary: 

The Investigative analyst will examine claims and other data sources to detect potential fraudulent activity. They will conduct extensive research from both internal and external sources, to identify patterns, trends and anomalies that require further investigation. The investigative analyst will develop investigations from the patterns, trends or anomalies identified and document all relevant activity/elements in accurate detail and in a timely manner within the investigative case management system. They will prepare reports regarding the conclusions and recommendations drawn from the data to present information to Investigative Services management, state insurance fraud bureaus and/or law enforcement. They will also make recommendations for future policies and procedures that will help detect, identify and/or prevent future fraud. The analyst must maintain a solid understanding of AmTrust’s mission, vision, and values and uphold the standards of the AmTrust organization.


Responsibilities: 

  • Analyze claim data and analytical software to detect patterns of potential fraud.
  • Collect data utilizing open source, law enforcement and third-party data to support lead generation and build out cases.
  • Complete database searches and queries that are unique to each project.
  • Utilize analytical software to review data and support investigation.
  • Analyze information gathered by investigation and develop inferences from the data collected.
  • Interview providers, claimants, witnesses, or any other individual(s) necessary to complete a case review or project.
  • Develop detailed reports and link analysis charts that clearly define the data collected, investigation conducted, and conclusions identified.
  • Prepare evidence package for referral to state insurance fraud bureaus and law enforcement agencies.
  • Communicate with state insurance fraud bureaus and law enforcement and respond to any subpoenas and/or requests related to prosecution.
  • Work with management to develop and implement policies and procedures to prevent future fraud.

 

Qualifications: 
Required:

  • An associate or bachelor’s degree in criminal justice or a related field from an accredited college or university OR five years of insurance claims investigation experience OR professional investigation experience with law enforcement agencies OR seven years of professional investigation experience.
  • Demonstrated ability to research, interpret and analyze large amounts of data and make an informed, calculated decisions.
  • Respect for confidential information.
  • Performs other functionally related duties as assigned.
  • Excellent problem solving, organizational, communication, and time management skills.

Preferred: 

  • Experience with ISO NetMap Is preferred, but not required.

 

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time.

 

*** Note: The job title on the AmTrust Careers page is listed as "SIU Investigator", but the position is for an Investigative Analyst. ***