Senior Investigator jobs at PacificSource Health Plans - 30 jobs

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $70,400.00 - $116,200.00 Target Openings 1 What Is the Opportunity? Travelers Investigative Services provides industry-first resources designed to detect and deter fraudulent claims. Using some of the most comprehensive technology available, we have the abilities and expertise to identify potential risks and combat fraudulent practices. As an SIU Investigator, you will analyze, summarize and prioritize information to uncover potentially fraudulent activity. The investigator, supporting a Claim Center, will investigate claims deemed suspicious in nature within all lines of business. The investigator will conduct thorough and comprehensive investigations in a dynamic, fast paced environment. This investigator supports Northern Oregon and southern Washington. The ideal candidate should live within this territory and be able to commute to the Lake Oswego office as needed. What Will You Do? * Conducts insurance investigations including applicable data base searches with a focus on uncovering all potentially fraudulent aspects of a claim. Periodically engages in specialized investigative area, including Medical, Cyber, Cargo, Fire Motive & Opportunity, etc. * Analyzes, monitors and summarizes technical information into actionable investigative strategies. Applies the techniques of critical thinking to dismantle complex problems and reasoning through to its logical conclusion. * Provides exceptional customer service by maintaining contact with business partners, customers and external resources throughout the life of each investigation, including liaison network with claim, legal, underwriting partners, public officials, law enforcement officers and others to obtain assistance in conducting investigations. * Serves as the subject matter expert (liaison) on fraud to business and industry partners. * Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation. * Applies Local, State and Federal statutes to ensure investigations are carried out within the requirements of applicable law and local office expectations. * Identifies cases for potential insurance fraud prosecution and submits questionable claims to the National Insurance Crime Bureau. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree. * Analytical and problem-solving skills to use and interpret information and facts as well as apply critical techniques to investigative process. * Strong case management skills and the ability to manage your own work independently. * Ability to work in a high volume, fast paced environment managing multiple shifting priorities. * Influence and conflict management skills * Working level knowledge of insurance and claim operations, Commercial Lines, Personal Lines, and Workers Compensation insurance products. What is a Must Have? * Two years of investigative experience or a minimum of three years insurance claim or underwriting or legal related experience. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. * Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************