Job Description

The Special Investigations Unit ("SIU") is looking for someone who can demonstrate the WCF values to join their team as a Special Investigator . This is a full-time, exempt position that reports to the SIU Manager.

The person in this position works out of WCF's Sandy, Utah headquarters or out of the California office located in Roseville, CA. Hybrid (office/home). 

This position is open to internal and external candidates.

Responsibilities

• Conduct investigations into suspected fraudulent claims involving claimants, providers and policyholders
• Gather and analyze evidence, including financial records, surveillance, social media and public databases
• Interview witnesses and individuals utilizing investigative techniques
• Prepare detailed investigative reports for internal use, claims decisions and legal proceedings
• Testify in depositions, administrative hearing or court when required
• Collaborate with internal departments (claims, legal, underwriting, auditing, finance) and external partners (law enforcement, attorneys, state fraud units, surveillance vendors)
• Identify fraud trends and contribute to analytics, fraud alerts and training programs
• Ensure compliance with applicable fraud reporting laws and regulatory SIU requirements
• Maintain case confidentiality and adhere to WCF's ethical and operational standards
• Must be self-motivated and able to work as a team member.
• Must have proficiency in use of computer databases and word processing software.
• Skills in verbal and written communication, problem solving, interpersonal relations, and time-management.
  
• Demonstrate skills in criminal investigative interview methods, documentation and record keeping, knowledge of
  workers' compensation laws and processes and of the criminal justice system.

Qualifications

• Bachelor's degree preferred
• Minimum 2 yrs experience investigating insurance fraud, including areas such as workers comp, medical, provider, claimant, property & casualty or auto cases.
• Professional certifications such as Certified Fraud Examiner or Certified Insurance Fraud Investigator preferred.
• Proficiency in investigative techniques, including surveillance, interviews and background investigations.
• Strong analytical and problem solving skills with the ability to detect fraud patterns, interpret complex data, and apply critical thinking to investigations
• Familiar with investigative tools and technology, including claims systems, fraud detection software, public records databases, and online research platforms
• Solid understanding of insurance fraud statutes, privacy laws, and regulatory reporting requirements
• Ability to prepare investigative reports suitable for legal proceedings or regulatory review.
• Excellent written and verbal communication skills
• Demonstrate integrity, professionalism, and high ethical standards
• Organizational and time management skills with the ability to manage multiple cases and meet deadlines

An internal candidate should have six months in their current position, have acceptable job performance, and must notify their current supervisor that they have applied for the position.

WCF Insurance offers an extensive compensation package. Benefits include Medical, Dental, and Vision insurance, company paid life insurance, 401K with a generous 6% employer match and additional benefits such as an Employee Assistance Program (EAP) and time off to volunteer in the local community. All employees earn 4 weeks of vacation in their first year. Expected salary for this position is $70,000 - $100,000 depending on location , experience , and education .

OUR PEOPLE

WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive.

WCF INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER

WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.

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