Job Description

SIU Investigator Location Hybrid remote in Bethlehem, PA : 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, report suspected fraud to state and federal agencies where required/appropriate and assist with responses to inquiries from state insurance departments or other law enforcement/regulatory agencies. The candidate will be responsible for handling multiple projects simultaneously and work independently to bring them to a successful resolution. You will

• Conduct start to finish investigations into cases of fraud or suspected fraud arising from any of Guardian's businesses. The successful candidate will lead investigations that include unusually difficult, sensitive, or urgent issues with due regard for 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.
• Effectively conduct interviews with individuals from all socio‐economic levels. Obtain all information and evidence relevant to the resolving the investigations, including accurate signed statements where necessary and appropriate.
• Analyze and appraise evidence to develop an informed objective opinion.
• Communicate investigative results and evidence to stakeholders in a professional, prompt, impartial, confidential, and accurate manner.
• Utilize outside investigative agencies on a case‐by‐case basis where economically feasible. Evaluate the service's effectiveness and make recommendations for future usage.
• Utilize FCRM system to effectively manage fraud alerts, identify potential fraud and abuse, identify, and analyze patterns, triage cases, and drill down through layers of data.
• Utilize various database and online sources of information. Creatively use online tools to develop information and evidence. Utilize databases such as Thomson Reuters and LexisNexis.
• Negotiate and assist with drafting settlements with providers, attorneys, corporate entities, and our insureds where appropriate.
• Report fraud or suspected fraud cases to the appropriate governmental agency in jurisdictions where required by law and where appropriate.
• Investigate allegations of employee fraud/misconduct.
• Assist in completing risk assessments, creating, and presenting fraud trainings and presentations, and providing advice and counseling about fraud controls to various stakeholders.
• Attend industry events such as NHCAA conferences. Develop and maintain contact with industry peers, regulators, and law enforcement.
• Assist in the completion of confidential fraud case investigations, including the filing of Suspicious Activity Reports (SARs) and Continuing Activity Reports (CARs), when applicable.
• Assist in high level investigations as directed by senior management.
You have
• 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 agencies, or
• 7 years of professional investigation experience involving economic or insurance related matters.
• CFE designation or NHCAA certifications
• Ability to extract information from non‐traditional sources.
• Strong analytical and problem-solving skills.
• Ability to creatively and effectively use databases and online tools to develop information.
• Regularly demonstrate initiative and ability to multitask.
• Strong research background.
• Outstanding communication skills (written and verbal).
• Self‐Motivated with the ability to thrive in a non‐structured environment.
• Strong Microsoft Word, Excel, PowerPoint skills
Location: Bethlehem, PA - Guardian office - Hybrid: 2 days in office, 3 days working from home. #LI-Hybrid Salary Range $48,190.00 - $72,280.00 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. 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. 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. Accommodations Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. 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 .

Job Tags

Holiday work, Full time, Immediate start, Remote job, Work from home, Flexible hours,

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