Job Description
Job Description
The Special Investigations Unit ("SIU") is looking for someone who can demonstrate the WCF values to join their team as a Special Investigator. This is a Hybrid full-time, exempt position that reports to the SIU Manager and works out of WCF's Sandy, Utah headquarters. This position is open to internal and external candidates.
Responsibilities
- Conduct investigations into suspected fraudulent claims involving claimants, providers, and policyholders.
- Gather and analyze evidence including financial records, surveillance, social media, and public databases.
- Interview witnesses and involved parties using investigative techniques.
- Prepare detailed investigative reports for internal use, claims decisions, and legal proceedings.
- Testify in depositions, administrative hearings, or court as needed.
- Collaborate with internal departments (claims, legal, underwriting, auditing, finance) and external partners (law enforcement, attorneys, state fraud units, surveillance vendors).
- Strong analytical skills with the ability to detect fraud patterns, interpret data, and support fraud analytics, alerts, and training.
- Ensure compliance with SIU and fraud reporting laws through a strong understanding of fraud statutes, privacy laws, and regulatory requirements.
- Maintain confidentiality and adhere to ethical and operational standards.
- Work independently and as part of a team to manage caseloads effectively.
Qualifications
The most qualified candidate will have:
- Bachelor's degree preferred
- Investigative experience in law enforcement, insurance investigations, or a related field.
- Professional certifications such as Certified Fraud Examiner or Certified Insurance Fraud Investigator preferred.
- Skilled in investigative techniques (e.g., surveillance, interviews, background checks) and in preparing reports suitable for legal or regulatory use.
- Experience with claims handling or investigations in Commercial Property & Casualty, Workers' Compensation or Medical Insurance is a plus.
- Familiar with investigative tools and technology, including claims systems, fraud detection software, public records databases, and online research platforms.
An internal candidate should have six months in their current position, have acceptable job performance, and must notify their current supervisor that they have applied for the position.
OUR PEOPLE
WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive.
WCF INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER
WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.
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