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Special investigation unit investigator skills for your resume and career
15 special investigation unit investigator skills for your resume and career
1. Management System
A management system is a set of policies, processes, and procedures taken by an organization or a business to ensure it can fulfill its tasks and achieve its objectives. A management system makes sure that the company excels financially and improves the user experience. The management system also takes care of the worker's and employees' needs and manages their workload and oversees their performance. Apart from interior matters of the company, a management system also deals with exterior matters like legislations, tax matters, and law issues.
- Investigated allegations of possible fraud and monitored computer based case management system for client compliance.
- Participated in testing of new case management system to assist in identification of process improvements.
2. BSA/AML
- Performed detailed analytical account investigations pertaining to potential BSA/AML violations.
- Investigated and opened cases on customers and non-customers who have potentially engaged in activity which goes against federally mandated BSA/AML regulations.
3. FinCEN
- Report and investigate matched individuals/entities and address inquiries directly from FinCEN.
- Report findings to FinCen after full investigation
4. Anti-Money Laundering
Anti-Money Laundering or, as it is often shortened to, AML is the name of a set of laws, regulations, and similar rules and rulings which are crafted and applied with the goal of preventing people from engaging in and successfully doing money laundering.
- Insured Compliance with regulatory requirements including Bank Secrecy Act, Anti-Money Laundering, OFAC, USA Patriot Act, Privacy Act.
- Maintain awareness and insight of the various types of risks that affect businesses from an Anti-Money Laundering perspective.
5. Law Enforcement Agencies
- Secured and shared information with local law enforcement agencies, National Insurance Crime Bureau and other federal/state law enforcement agencies.
- Worked extensively with local, state and Federal law enforcement agencies and prosecutors to coordinate resources and exchange intelligence.
6. Conduct Investigations
- Conduct investigations via interviews with policy holders, medical professionals, and law enforcement.
- Conduct investigations involving allegations of violations of the Texas Penal Code.
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- Prepared cases for and followed through with civil litigation and criminal prosecution in multiple jurisdictions.
- Conducted investigations to determine possible civil or criminal litigation.
8. Bank Secrecy Act
- Conduct Bank Secrecy Act monitoring of prior investigations for additional suspicious activity.
- Conducted detailed analyses of daily structuring, velocity of funds and outbound/inbound transactions reports in accordance with the Bank Secrecy Act.
9. Due Diligence Research
- Perform enhanced due diligence research as required on high risk clients.
10. Investigative Reports
Investigative report are used in court to find facts, document certain subjects, to recover important records, or to recover certain file forms.
- Completed in person interviews of involved parties, database searches, investigative reports and recommendations on investigations performed.
- Prepare and submit investigative reports in preparation of civil and criminal proceedings.
11. Medicaid
- Determine corrective actions required and provide final recommendation and referral to the State of Georgia Medicaid Fraud Control Unit.
- Attend information sharing meetings with law enforcement, State Medicaid Agencies and other managed care organizations.
12. Insurance Fraud
Insurance fraud refers to any willful illegal act committed with the intent to deceptively receiving payment from an insurer, insurance company, or agent for financial gain or advantage to which they are not entitled. Deceitful claims make up a significant proportion of all claims received by the insurers and cost enormous sums of money each year. This may include the exaggeration of otherwise justified claims, intentional misrepresentation of the facts, or complex organized manipulation of the claims process to achieve financial advantage where no actual loss has occurred.
- Identified and investigated cases of suspected insurance fraud.
- Tested and received the Certified Insurance Fraud Investigator (CIFI) designation from the International Association of Special Investigation Units.
13. Fraudulent Claims
- Conducted investigations of individuals suspected of filing fraudulent claims to obtain data on character, financial status and personal history.
- Recommended punitive action on fraudulent claims.
14. Claims Investigations
- Conducted workers' compensation and liability claims investigations.
- Assist claim examiners in claims investigations.
15. Insurance Claims
- Saved company hundreds of thousands of dollars by recognizing unscrupulous medical practices and unjustified insurance claims.
- Perform Worker's Compensation investigations, automobile and boat insurance claims, undercover and fraud investigations.
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List of special investigation unit investigator skills to add to your resume
The most important skills for a special investigation unit investigator resume and required skills for a special investigation unit investigator to have include:
- Management System
- BSA/AML
- FinCEN
- Anti-Money Laundering
- Law Enforcement Agencies
- Conduct Investigations
- Litigation
- Bank Secrecy Act
- Due Diligence Research
- Investigative Reports
- Medicaid
- Insurance Fraud
- Fraudulent Claims
- Claims Investigations
- Insurance Claims
- CMS
- General Liability
- Fraud Awareness Training
- Health Plan
- In-Depth Investigations
- Subpoenas
- Fraud Investigations
- Local Law Enforcement
- Arbitration
- Claims Handling
- Oath
- Comprehensive Reports
- Background Checks
- CPT
- Scene Investigations
- Fraud Cases
- Fraud Schemes
- Background Investigations
- Nicb
- PIP
- FWA
- ISO
- Federal Law Enforcement
- Child Abuse
- Fraud Indicators
- Police Reports
- Criminal Cases
- Claims Data
- Federal Agencies
- Government Agencies
- Criminal Investigations
Updated January 8, 2025