Federated Mutual Insurance - Rancho Cordova, CA
posted 16 days ago
About the position
At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values.
Responsibilities
- Conduct thorough investigations of referred cases and collaborate with claims professionals to achieve optimal outcomes.
- Provide technical guidance on fraud-related issues, claim negotiation, and settlement.
- Maintain expertise in medical terminology, coding, billing, fraud investigation techniques, legal documentation, and surveillance management.
- Partner with law enforcement to assist in the prosecution of fraudulent activities.
- Ensure adherence to regulatory requirements for fraud reporting.
Requirements
- Bachelor's degree or equivalent work experience.
- At least 3 years of experience with a commercial insurance company or in special investigation responsibilities, showcasing strong investigative, analytical and communication skills.
- Proficiency in Microsoft Office Suite or similar software.
- Integrity and confidentiality in handling sensitive information.
- Ability to obtain and maintain required insurance licensing.
Benefits
- Competitive compensation
- Enticing bonus programs
- Cost-effective health insurance
- Robust pension and 401(k) offerings
- Paid volunteer time
- Opportunities for gift matching
