Job Description
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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 : 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.
ESSENTIAL FUNCTIONS And RESPONSIBILITIES - Proactively assists fraud & compliance leadership in the prevention, detection, investigation, and resolution of fraud & compliance matters through analysis and investigation.
- Conducts thorough investigations into fraud and compliance matters, including initial case assessment, planning, evidence collection, stakeholder interviews, and reporting.
- Oversees fraud compliance efforts related to employee dishonesty, vendor fraud, financial fraud schemes against Sedgwick and carrier/clients.
- Oversees regulatory efforts related to AML, FCPA, and Sanctions regulations across the Americas, ensuring alignment with global standards where applicable.
- Collaborates with organizational stakeholders to investigate and resolve fraud, compliance, regulatory, and other significant matters.
- Ensures timely and accurate documentation of investigative findings.
- Testifies in criminal, civil and/or administrative proceedings.
- Maintains liaison relationships with law enforcement and district attorneys.
- Contributes to the root cause analysis on internal and external fraud & compliance events.
- Assists in the development, presentation, and compliance of fraud training for the organization.
ADDITIONAL FUNCTIONS And RESPONSIBILITIES - Performs other duties as assigned.
- Supports the organization's quality program(s).
Qualifications Education & Licensing Bachelor's 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 combination of education and experience preferred.
Skills & Knowledge - Technical Skills : Legal knowledge of fraud & compliance laws, claims management, experience with 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 Sedgwick is committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with applicable laws.
- 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.
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.
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.
Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see
sedgwick.com If you have questions about this posting, please contact support@lensa.com
Job Tags
Full time, Local area,