Fraud & Compliance Investigator

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Fraud & Compliance Investigator

PRIMARY PURPOSE OF THE ROLE:  To research, investigate and analyze reported, alleged or suspected fraud and other compliance issues as it relates to or impacts Sedgwick, carrier partners and clients; to use “big data” maintained by Sedgwick and public and private indices to advance the prevention, detection, investigation and resolution of fraud; and to manage and maintain relationships with internal and external stakeholders, including carrier partners, clients, departments of insurance, law enforcement and prosecutors.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. 
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 
• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. 
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ESSENTIAL RESPONSIBILITIES MAY INCLUDE

• Proactively assists with fraud and compliance initiatives such as the prevention, detection, investigation and resolution of fraud & compliance issues through research, investigation and analysis.

• Supports the corporate anti-fraud mission including the prevention, detection, investigation and resolution of fraud & compliance issues through research, investigation and analysis.
• Manages the annual fraud reporting process for carrier partners and state regulators.
• Supports Sedgwick SIU through regulatory compliance reporting and requests.
• Conducts and analyzes the mining of “big data” using advanced data analysis techniques to detect aberrancies and outliers to identify the presence fraud symptoms.
• Develops advanced algorithms, queries and reports to detect potential fraud or other compliance trends and patterns.
• Manages the Sanctions Screening process for anti-money laundering (AML), Foreign Corrupt Practices Act (FCPA), Office of Foreign Assets (OFAC) and other state countries.
• Contributes to the root cause analysis on internal and external fraud and compliance events.
• Monitors industry news and fraud and compliance trends to develop actionable intelligence for fraud and compliance risk identification and mitigation.

QUALIFICATIONS

Bachelor's degree in business from an accredited college or university preferred.  Fraud, compliance, privacy, anti-money laundering certification preferred. Five (5) years of related experience including one (1) year in research, fraud prevention, or detection or a combination of education of experience required.

TAKING CARE OF YOU BY

• Offering a blended work environment. 
• Supporting meaningful work that promotes critical thinking and problem solving.
• Providing on-going learning and professional growth opportunities.
• Promoting a strong team environment and a culture of support.
• Recognizing your successes and celebrating your achievements.
• We offer a diverse and comprehensive benefits package including:
  • Three Medical, and two dental plans to choose from.
  • Tuition reimbursement eligible.
  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
  • 4 weeks PTO your first full year.

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:  Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:  Computer keyboarding, travel as required

Auditory/Visual:  Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.  They are not intended to constitute a comprehensive list of functions, duties, or local variances.  Management retains the discretion to add or to change the duties of the position at any time.

#REMOTE #LI-TS1

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.