Field Investigator - South Bay/Central Valley

Company: Sentry Insurance
Location: San Jose
Posted on: April 19, 2025

Job Description:

Creates and maintains an ongoing awareness on the part of all claim file handlers toward recognition of "red flags" in claim cases, leading to the detection, investigation and mitigation of potentially fraudulent and/or inflated claims. Performs a variety of duties and responsibilities to bring about resolution, compromise, denial and/or prosecution of fraudulent claims. Responsible for the assignment to independent contractors for specific antifraud investigation. Is accountable for controlling costs for contracted activities.The ideal candidates preferred location for this position is in the South Bay/Central Valley area with travel required in and around that area.What Youll Do:As a Special Investigator, you will conduct basic to moderately complex claims investigations on potentially suspect/inflated auto, workers compensation, and commercial claims which may include but is not limited to compiling and analyzing information from internal and external sources, conducting interviews, hiring independent contractors, and referring claims to various law enforcement entities as required by law.

• Investigate claims, both inside and outside the home office, to identify suspect or inflated claims across all lines of business. This may include conducting scene investigations, taking recorded statements, assigning independent contractors, etc.
• Compile and analyze data and information from these internal and external sources to aid in making suspect claims decisions that adhere to state and federal laws. Verify legitimacy of documents as necessary.
• Conduct recorded interviews and examinations under oath of insureds, claimants, and witnesses for claims that involve suspicious indicators.
• Maintain detailed investigation notes within SIU case management and claim systems, prepares summary reports to capture findings and recommends course of action to management which may include referring to law enforcement.
• Communicate with company, industry and law enforcement fraud agencies (i.e. NICB, Index Bureau, FBI, etc.)
• Communicate non-confidential material to claim staff concerning conclusions on suspicious claims submitted to the SIU.
• Represents the company in court appearances as a possible witness on suspected fraudulent claims, including state and/or federal courts or grand jury hearings.
• Motivate the claim staff to combat fraud and inflated claims using techniques such as creating office banners and visual aids, publishing specific case results and conducting meetings.What it Takes:
  • Bachelors degree or equivalent work experience, degree in Police Science, Police Administration or Criminal Justice beneficial.
  • 2+ years of related work experience required, 4+ preferred
  • The ability to speak both Spanish and English is preferred
  • Ability to travel as necessary to satisfactory complete their job responsibilities as assigned.
  • Prior experience in some aspect of law enforcement and/or criminal investigation preferred.
  • Strong investigative skills along with ability work effectively with members of the claim staff and the law enforcement community.
  • Strong written and oral communication skills and the creativity to recognize potential fraud and develop a reasonable plan for investigating potential fraud cases.What You'll Receive:At Sentry, your total rewards go beyond competitive compensation. Below are some benefits and perks that youll receive.
    • As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.
    • Meal Subsidy available for associates who report to an office.
    • 401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future.
    • Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program
    • Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off
    • Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle.
    • Well-being and Employee Assistance programs
    • Sentry Foundation gift matching program to encourage charitable giving.
    • The salary range for this position in the state of California, based on qualifications and experience is between $76,728 - $105,501 annually.About Sentry:We take great pride in making Forbes list of Americas Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction.Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, were one of the largest and financially strongest mutual insurance companies in the United States. Were rated A+ by A.M. Best, the industry's leading rating authority.Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth.Get ready to own your future at Sentry. Opportunities await!Joe LarsenTalent Acquisition SpecialistJoe.Larsen@sentry.comEqual Employment OpportunitySentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.Required
      Preferred

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Keywords: Sentry Insurance, Fremont , Field Investigator - South Bay/Central Valley, Other , San Jose, California