Evaluate SIU referrals to identify suspicious fraud indicators and create investigative plans.
Conduct data analysis and manage vendor assignments while collaborating with law enforcement.
Prepare detailed investigative reports and referrals to NICB and Departments of Insurance.
Core Specialty is a multi-state commercial insurance carrier offering property and casualty insurance for small to mid-sized businesses. The company has underwriting offices across the U.S. and emphasizes niche markets and local distribution.
Conduct thorough investigations of potentially fraudulent insurance claims, analyzing evidence and documenting findings.
Interview claimants, witnesses, and relevant parties to gather accurate information and support case resolutions.
Collaborate with claims professionals and vendors to manage complex investigations from review through resolution.
Our partner company specializes in fraud investigation and insurance claim integrity. The organization offers a collaborative remote work environment focused on innovation, accuracy, and customer protection.
Investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis and interviews.
Analyze information, report findings, and recommend settlements or denials while supporting legal proceedings.
Conduct training on fraud detection and maintain knowledge of relevant laws and regulations.
Cotiviti is a healthcare analytics company that helps clients reduce costs and improve outcomes through data-driven insights. As a global leader in payment accuracy and network performance, Cotiviti fosters a collaborative and inclusive culture.
Administer fraud, waste, and abuse (FWA) duties, including investigations, audits, and corrective actions.
Prepare reports, correspondence, and data analysis for internal and external stakeholders.
Assist in policy development, training, and regulatory compliance for FWA programs.
CareOregon is a nonprofit, mission-driven health plan focused on providing care to low-income Oregonians. With around 1,000 employees, it fosters a culture of equity, diversity, and inclusion, and offers comprehensive benefits.
Manage an assigned pending of claims from the Security Profit Center, including verifying coverage, interpreting complex coverage issues, and writing reservation of rights and declination letters.
Conduct thorough investigations, evaluate claims within authority, assess risk transfer and recovery potential, and manage litigated claims.
Provide superior customer service to agents, insureds, and others, and meet with customers to discuss claims capabilities.
Crum & Forster (C&F), founded in 1822, provides specialty and standard commercial lines insurance products through admitted and surplus lines companies, with an AM Best rating of A+ (Superior). With over 2000 employees across the US, C&F has earned recognition as a great place to work, including a 2025 Great Place to Work Award for its employee-first focus and commitment to diversity and inclusion.
Manage an assigned pending of property claims under appropriate supervision.
Verify coverage, document damage, investigate issues, and negotiate settlements.
Engage consultants, keep insured informed, and handle claims of varying complexity.
Crum & Forster provides property & casualty, accident & health, specialty and standard commercial lines insurance solutions. With 3,000 employees and a 200-year history, the company has an employee-first culture and has earned awards such as Great Place to Work and Fortune 100 Best Companies to Work For.
Lead project-scale investigations of complex fraud events including coordinated rings and systemic patterns, from initial signal through root-cause analysis and leadership-ready readouts.
Serve as the senior investigative authority, setting the bar for case quality and acting as the default escalation point for the team's hardest cases.
Drive fraud rule and process changes by translating investigative findings into measurable controls, and represent Risk Ops findings to cross-functional leadership.
Tilt is a mobile-first fintech company that uses machine learning-powered credit models to assess financial potential beyond traditional credit scores, serving millions of customers worldwide. With a virtual-first, globally distributed team across 14 countries, Tilt fosters a culture of excellence, impact, and mutual respect.
Investigates claims by determining applicable policy coverage, evaluates, negotiates and settles assigned claims.
Initiates contact with insureds, claimants, and all relevant parties to gather basic information, obtain recorded statements (when necessary), and explain the overall claims process.
Completes physical and/or virtual inspections of damaged property (when necessary), evaluates damages, and prepares written estimates according to policy provisions and liability.
COUNTRY Financial provides personal and business insurance products as well as retirement and investment services to nearly one million households. The company prides itself on a collaborative culture where employees can make an impact.
Investigate and analyze suspected fraud cases affecting Veriff’s customers.
Develop new countermeasures and strategies to address emerging fraud patterns while minimizing false positives.
Collaborate with cross-functional teams to improve fraud detection processes and ensure product readiness.
Veriff is a global identity verification platform that helps businesses verify and safeguard users online. The company is backed by investors including Accel, Alkeon, IVP, Tiger Capital, and Y Combinator, has offices in the US, UK, Spain, and Estonia, and is dedicated to being a benchmark for trust online.
Oversee internal and external staff conducting fraud and complaint investigations, including training, monitoring, and management.
Gather and analyze evidence using investigative techniques to uncover fraudulent schemes and identify responsible parties.
Collaborate with stakeholders to develop risk-based prevention strategies and controls to safeguard company assets.
Forbright is a nationwide full-service bank and commercial lender focused on building a brighter future for clients and communities. We are a dynamic, high-energy, and fast-paced organization with a culture of collaboration, inclusion, flexibility, and giving back.