Investigator I (Bilingual Preferred)

Salary Range: $42,000 - $98,000

Job Posting End Date: May 29, 2024

 

We’ve Got You Under Our Wing

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

 

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.

 

Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac.

 

Work Designation. This role is designated as a hybrid role, meaning you will be expected to work at an Aflac location in Columbus, GA, for at least 60% of the work week.  You will work from your home within the continental U.S. for the remaining portion of the work week. Details of this schedule will be discussed with your leadership.  

 

What does it take to be successful at Aflac?

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations

 

What does it take to be successful in this role?

• Microsoft Word: Basic

• Proficient in Microsoft Outlook, Excel and Access

• Basic understanding of both civil and criminal court proceedings, including rules of evidence

• Excellent presentation, oral, written, and interpersonal communication skills to effectively interact with senior management, internal and external customers, and agency representatives

 

Education & Experience Required

• Bachelor's Degree In Criminal Justice, Business Administration, or a related field
• One year of related work experience (law enforcement, SIU, insurance investigation, internal audit, etc.)

Or an equivalent combination of education and experience

 

Education & Experience Preferred

• Beginning progress toward one or more of the following designations/certifications: Fraud Claims Law Specialist (FCLS), Health Care Anti-Fraud Associate (HCAFA), or Certified Insurance Fraud Investigator (CIFI)
• Ability to proficiently read and write both English and Spanish 

 

Travel

Less than or equal to 10%

 

Principal Duties & Responsibilities

• Assists business units in recognizing and identifying indicators of fraud as a part of the normal business process; actively participates in Special Investigative Unit (SIU) associations, seminars, and training opportunities; stays abreast of current fraud trends and patterns; keeps management informed about any events or occurrences that could be construed to be fraud or other indications of problems

 

• Receives referrals of suspected fraud; conducts preliminary investigations to determine if the circumstances warrant an in-depth investigation, and investigates suspicious transactions and situations where evidence of fraud exists; develops a detailed investigative plan of action; conducts in-person or telephone interviews with witnesses, policyholders, physicians, associates, employers, and others identified during the investigative process; obtains recorded and/or written statements; conducts all investigations in a thorough and timely manner as required by procedures and legal requirements; provides status of investigations to management and to the referring business unit; prepares a summary and detailed report following standard format to ensure proper documentation of all reported cases and investigations; maintains and assembles files, working paper reports, and other documentation in the designated format and in accordance with the appropriate guidelines for the level of confidentiality and security required

 

• Maintains understanding and knowledge of the various state and federal insurance statutes; develops and maintains liaison relationships with law enforcement agencies; coordinates with federal, state, and local courts, and the appropriate state insurance department of investigations being worked or completed; prepares detailed evidence packages for referral to law enforcement and/or internal/external counsel; refers founded cases of fraud to these agencies for future criminal or civil action; testifies before civil and criminal courts and administrative hearings

 

• Performs other related duties and/or projects as required

 

Total Rewards

This compensation range is specific to the job level and takes into account the