Job Details

Fraud & Compliance Investigator

By joining Sedgwick, youll be part of something truly meaningful. Its 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, theres no limit to what you can achieve.

Newsweek Recognizes Sedgwick as Americas Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance

PRIMARY PURPOSE

To analyze and investigate reported, alleged, or suspected fraud and compliance matters related to Sedgwick operations, personnel, third?party vendors, and service providers; to identify fraud trends; prepare, document and produce internal reports and criminal referrals to state and federal enforcement agencies and regulatory bodies.

RESPONSIBILITIES

• Proactively assist fraud & compliance leadership in the prevention, detection, investigation, and resolution of fraud & compliance matters through analysis and investigation.


• Conduct thorough investigations into fraud and compliance matters, including initial case assessment, planning, evidence collection, stakeholder interviews, and reporting.


• Oversee fraud compliance efforts related to employee dishonesty, vendor fraud, and financial fraud schemes against Sedgwick and carrier/clients.


• Oversee regulatory efforts related to AML, FCPA, and Sanctions regulations across the Americas, ensuring alignment with global standards where applicable.


• Collaborate with organizational stakeholders to investigate and resolve fraud, compliance, regulatory, and other significant matters.


• Ensure timely and accurate documentation of investigative findings.


• Testify in criminal, civil and/or administrative proceedings.


• Maintain liaison relationships with law enforcement and district attorneys.


• Contribute to root?cause analysis on internal and external fraud & compliance events.


• Assist in the development, presentation, and compliance of fraud training for the organization.

ADDITIONAL FUNCTIONS

• Perform other duties as assigned.


• Support the organizations quality program(s).

QUALIFICATIONS

Education & Licensing
Bachelors degree in business or related field required; Certified Fraud Examiner (CFE) designation strongly preferred.

Experience
Six (6) years of fraud investigation, compliance, legal, or insurance experience or a combination of education and experience preferred.

Skills & Knowledge

• Technical: Legal knowledge of fraud & compliance laws, claims management, AI, regulatory interpretation and applications, Microsoft 365.


• Communication: Strong oral and written communication, presentation skills.


• Analytical & Organizational: Strong analytical, interpretive, and organizational skills.


• Interpersonal: Ability to work independently and in teams, manage multiple projects and stakeholder engagement and influence.

WORK ENVIRONMENT

• 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.

NOTE: This position requires a credit security clearance, confirmed through a background credit check.

Sedgwick is an Equal Opportunity Employer and a Drug?Free Workplace. Sedgwick is committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with applicable laws.

Were building a diverse, equitable, and inclusive workplace and recognize that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.