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AIG · 3 hours ago

Principal Claims Investigator

Atlanta, GA

Full-time

Onsite

Lead/Staff

AIG is a global leader in commercial and personal insurance solutions, and they are seeking a Principal Claims Investigator to enhance their claims handling experience. The role involves leading investigations into complex suspicious insurance claims, coordinating investigative resources, and maintaining professional relationships with various stakeholders.

BankingFinancial ServicesInsurance

Responsibilities

Obtain and preserve physical and documentary evidence to support investigations

Coordinate necessary investigative techniques and resources, such as fieldwork through internal or external field resources, interviews, etc. and ensuring quality is accurate, timely and appropriate on all cases

Handle a full caseload of primarily high complexity investigations including organized ring activity, provider fraud, premium avoidance, and other major case investigations across relevant jurisdictions while ensuring all tasks are completed properly

Testify and present evidence at administrative and criminal court proceedings as required

Establish and maintain professional working relationships with insureds, lawyers, corporate employees, vendors, police and relevant fraud bodies

Complete targeted claims reviews for all lines of business within AIG as assigned. This includes analysis, documentation of results and suggestions for improvement

Accurately identify and record all financial impact for cases worked in the case management system

Assist GIS and local management as appropriate in ensuring key deliverables and business objectives are met

Awareness of, and adherence to, local laws regarding techniques used for information gathering in countries where operating

Provide intelligence feedback to claims and underwriting departments regarding loss trends and opportunities for future fraud mitigation

Dedicated lead/liaison between internal and external support functions. Provide oversight, training, support, and management of daily activities to include reporting and analytics

Manage all aspects of the claims investigation, to include analyzing facts on issues in question, thorough review of interviews and statements of witnesses, employers, claimants and other relevant witnesses

Gather facts on issues in questions through open-ended interviewing and statement taking of witnesses, employers, claimants, and other relevant witnesses

Prepare objective and concise written reports of investigations when necessary

Identify, create, and complete fraud training for various lines of business supported by AIG

Serve as Subject Matter Expert (SME) on one or more fraud related topics or line of business

Complete focused claims reviews for all lines of business within AIG domestically as assigned. This includes analysis, documentation of results and suggestions for improvement

Assist team on ad-hoc duties, projects, and other assignments delegated by Managers/Leaders

Qualification

Claims investigationFraud detectionData analysisCriminal justice knowledgeMS Office proficiencyInsurance knowledgeWorkflow managementReport writingCommunication skillsTeam collaboration