Administrative Support handling clerical tasks for Medical Underwriting at Alberta Blue Cross providing health coverage for over 1.8 million members.
About the role
- SIU Investigator handling complex underwriting and premium fraud investigations at CNA. Collaborating with stakeholders and maintaining detailed records while ensuring compliance with best practices.
Responsibilities
- Initiates and manages suspected fraudulent underwriting and insurance premium investigations.
- Provides advice, direction, and support to underwriters, auditors, and other stakeholders.
- Leads detailed analysis and completion of thorough and timely investigations of suspected underwriting fraud.
- Develops and executes investigation strategy independently or in collaboration with professionals.
- Maintains detailed, accurate, and timely case records following established Best Practices.
- Makes recommendations for resolution by presenting evidence-based findings.
Requirements
- Bachelor's degree or equivalent professional experience.
- Minimum of three to five years of experience conducting investigations in insurance fraud, law enforcement, civil or criminal litigation, or similar field.
- Professional certification or designation related to fraud investigations strongly preferred (e.g., CFE, CIFI, FCLS, FCLA, or similar).
- Solid knowledge of property and casualty claim handling practices.
- Strong technical knowledge of practices and techniques related to investigations and fact finding.
- Ability to interact and collaborate with internal and external business partners, including outside agencies.
- Detail oriented with strong organization and time management skills.
- Strong ability to analyze complex, ambiguous matters and develop effective solutions.
- Proficiency with Microsoft Office applications and relational databases information querying techniques.
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible working hours
- Professional development opportunities
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