Job details

Senior Fraud Investigator

Title: Fraud Investigator

Division/Department:

Anti-Financial Crimes-Special Investigations Unit

The primary role of this position will be to investigate potential cases of fraud across the enterprise.

The successful candidate will also provide advice and counseling to business partners regarding potential fraud cases and anti-fraud controls and assist with responses to inquiries from state insurance departments or other regulatory agencies.

The candidate will be responsible for handling multiple projects simultaneously and work independently to bring them to a successful resolution.

Candidate Responsibilities

Principle Responsibilities:

Conduct investigations from start to finish into cases of fraud or suspected fraud across the enterprise, including situations where the questions raised, and the evidence sought are unusually difficult, sensitive, and urgent. Perform such investigations with due regard to the company's reputation, privacy considerations, exposure to liability, statutory compliance requirements, and legal ramifications.
Plan and develop the theory and scope of each assignment. Consider all civil and criminal options available to Guardian as part of each course of action. Determine priorities, thrust and direction of each investigation. Consider business ramifications to all areas of the company.
Conduct effective interviews with persons from all socio‐economic levels. Obtain accurate statements.
Analyze and appraise evidence to develop informed objective opinions.
Communicate investigative results and evidence to those concerned in a professional, prompt, impartial, confidential, and accurate manner.
Conduct complex investigations into incidents involving securities, investments and broker-dealer and investment advisory services.
Handle a full caseload of investigations into potential fraud involving Group Benefits products, including dental, disability, life and supplemental insurance.
Conduct investigations into potential fraud involving individual life, annuity and disability products.
Utilize outside investigative agencies on a case‐by‐case basis where economically feasible. Evaluate their service effectiveness and performance and make recommendations for future usage. Maintain connections in this area in all 50 states and various international areas.
Utilize the Financial Crime Risk management (FCRM) application to identify potential fraud and abuse, identify and analyze patterns, triage cases, and interpret data.
Utilize various databases including Thomson Reuters and LexisNexis and other online sources of information.
Negotiate settlements with providers, attorneys, corporate entities, and our insureds where appropriate. Assist with drafting of formal settlement agreements.
Report fraud or suspected fraud cases to relevant governmental agencies where required/appropriate.
Investigate internal fraud.
Assist in completing risk assessments, creating, and presenting fraud trainings and presentations, and providing advice and counsel about fraud controls to various stakeholders.
Assist with special projects such as the quarterly Fraud Bulletin, legislative compliance, public speaking assignments, and others.
Attend information‐sharing meetings with peer carriers or organizations such as NHCAA, ACFE, or LIMRA/LOMA.

Additional Responsibilities:

Investigate and resolve transaction monitoring alerts, including the escalation of such alerts into cases, when appropriate.
Assist in the completion of confidential fraud case investigations, including the filing of Suspicious Activity Reports (SARs) and Continuing Activity Reports (CARs), when applicable.
Report incidents of fraud to law enforcement or state insurance divisions where appropriate, providing the necessary documentation.

Assist in high level investigations as directed by senior management.
Support complex internal investigations.

Position Requirements:

One or more of the following: Bachelor’s Degree in Criminal Justice;or Bachelor’s Degree and 4 years of insurance investigation experience, or

5 years of professional investigation experience with law enforcement agency, or

7 years of professional investigation experience involving economic or insurance related matters.

CFE designation or NHCAA certifications
Series 7 certification (or ability to obtain within 6 months) -securities knowledge/experience a plus
Experience in preparing and conducting interviews of subjects and witnesses a plus
Ability to extract information from non‐traditional sources.
Strong analytical and problem-solving skills.
Regularly demonstrates initiative and ability to multitask.
Strong research skills.
Outstanding communication skills (written and verbal).
Self‐Motivated with the ability to thrive in a non‐structured environment.
Strong Microsoft Word, Excel, PowerPoint skills

Travel & Location

Hybrid with two days a week in our Bethlehem PA, Holmdel NJ, or Hudson Yards NY office.

Minimal travel - <10%

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Salary Range

$55,100.00 - $90,530.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.

Health Care

Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits
Dental plan
Vision plan
Health care accounts – flexible spending, health reimbursement, and health savings accounts
Critical illness insurance

Life and Disability Insurance

Company-paid Life and Disability insurance plus voluntary supplemental coverage
Accident insurance

Retirement and Financial

401(k) retirement plan with a company match, plus an annual age/service-based Company contribution and an annual profit-sharing contribution, if applicable
Complimentary 1:1 financial guidance with a licensed Fidelity representative

Time Off and Remote Work

Flexible work arrangements (part in-person/part remote)
Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement
Personal holidays for colleagues to use in recognition of religious, cultural, or civic days
Paid parental leave and paid family and medical leave policies

Emotional Well-being and Work-Life

Emotional well-being, mental health, and work/life resources powered by Spring Health
Wellness programs, including fitness program and equipment reimbursement
Child, adult, and elder back-up care support through Bright Horizons
Adoption assistance
College planning
Tuition reimbursement
Student loan assistance
Commuter benefits in select metropolitan areas

Justice, Equity, Diversity & Inclusion (J.E.D.I.)

Employee Resource Groups that advocate for inclusion and diversity
J.E.D.I. certification and training programs
Matching gifts/volunteering

Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact

applicant_accommodation@glic.com

By Guardian Life

In 2021, we expanded our purpose as an organization to inspire well-being™. We established Guardian’s North Star going forward and began a three- to five-year process of transformation and progress. The effort gained momentum last year across our ...

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FUNDING

Private

INDUSTRY

Insurance Carriers

TEAM SIZE

5001-10000

LOCATION

Hybrid, based in New York, NY

DATE POSTED