Fraud Specialist - Austin

Under general supervision, responsible for the oversight and investigation of  workers? compensation fraud, medical provider fraud, premium fraud and other complex or sensitive investigations.  Provides technical guidance and advanced training to claims personnel in branch offices.  Ensures that investigations are conducted in accordance with company policies and objectives with due regard to applicable rules and regulations required under the insurance and labor laws, and civil and criminal codes of the applicable State and the United States Government. 


 












College degree or equivalent business experience.  Successful law enforcement career with detective or investigative assignments may be helpful.


 


Must demonstrate strong analytical abilities with a minimum of 3 years combined investigation or audit/analyst experience.


 


Expert knowledge of the Labor Code, Penal Code, Insurance Code prevailing case law and Workers' Compensation claims investigative techniques.


 


Excellent interpersonal, verbal and written communication skills.  Bi-lingual preferred. 


 


PC literacy and experience with data base applications required. 


 


Excellent time management, organizational and negotiation skills. 


 


Valid Driver's license in good standing. 








 







REF: CAAR155052

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