Supervising Claims Fraud Investigator

Executive/Senior Staff Brooklyn, NY


Description

Position at New York City Transit

JOB INFORMATION: 

Title: 

Supervising Claims Fraud Investigator 

Authority: 

NYCT 

Department: 

Office of the President  

Division/Unit: 

Office of the CAO 

Location: 

130 Livingston St, Brooklyn, NY 11201 

Hours: 

9:00 AM – 5:00 PM 

Telework (if Applicable): 

  

Reporting Manager (if Applicable) 

Director 

Deadline (if Applicable) 

  

  

  

Compensation, Union: NYCT-MANAGERIAL CAREER & SALRY 

$83,036 – $103,796 (Grade 003) 

  

POSITON SUMMARY: 

Lead special investigations unit in the detection and investigation of Workers' Compensation fraud as well as other related employee availability related matters.  Oversee investigations including the supervision and quality control of fieldwork, research, surveillance, interviews, social media, open-source methods, undercover methods and other means. 

  

RESPONSIBILITIES: 

  

  • Manage and develop flow of referrals from internal, external and Third Party Administrator sources.  

  • Assist in the training of investigators, claim examiners and related staff in the recognition of suspicious claim activity.    

  • Assist counsel in the preparation of matters for hearings, trials and labor arbitrations.   

  • Form and lead joint investigations with law enforcement agencies and insurance carriers. 

  • Manage inventory through review of investigative work product of assigned staff. Guide and counsel investigators on with their assignments.  

  • Assign matters and ensure the skillsets/resources necessary for success are available and utilized.   

  • Complete high level complex investigations. 

  • Performs other duties as assigned 

  • Complies with all policies and standards 

  • May be required to work hours outside regular work hours, as applicable 

  • Observes the work performed by contractors, as applicable 

  • Reviews invoices and approves them if the work has contractual standards, as applicable 

  • Addresses performance issues with the contractor when possible, as applicable 

  • Escalates issues to other parties when needed, as applicable 

  

EDUCATION AND EXPERIENCE: 

  

  • Baccalaureate from an accredited college in Arts/Sciences (BA/BS) or an equivalent combination of education and experience. 

  • 7 years of insurance claim investigations or law enforcement detective work 

  • 3 years of Insurance or Medial Fraud Investigation Experience 

  

DESIRED SKILLS: 

  

  • Knowledge of medical terminology, social media and occupational injury   

  • Experience with surveillance and secuirty camera systems  

  • Experience testifying 

  • Undercover operations  

  • Strong writing skills 

  

SELECTION METHOD 

  

Based on evaluation of education, skills, experience, interview, and written assessment. 

All selected candidates will be subject to a full background investigation that includes employment and education. Discrepancies may lead to dismissal. 

  

OTHER INFORMATION 

  

Appointment may be at a comparable level to current level of selected candidate. (If necessary) 

  

As an employee of MTA NYC Transit, you may be required to complete an annual financial disclosure statement with the state of New York, if your position earns more than $101,379 (this is subject to change) per year or if the position is designated as a policy maker. 

  

For 55-a eligible titles: Candidates selected for this position may be placed in a competitive or non-competitive class position based on their qualifications. Qualified candidates who are placed in a competitive class position are eligible for the 55-a Program. Please indicate in your cover letter and in the upper right corner of your resume that you would like to be considered for the position under the 55-a Program. For detailed information regarding the 55-a Program, please visit the following link https://www1.nyc.gov/site/dcas/employment/55-a-program.page  

  

TA APPLICANTS MUST BE IN A PERMANENT CIVIL SERVICE STATUS IN THE TITLE(S). IF YOU ARE ON AN ESTABLISHED LIST, YOUR LIST NUMBER MUST BE REACHABLE TO BE CONSIDERED FOR APPOINTMENT. The Metropolitan Transportation Authority is North America's largest transportation network, serving a population of 15.3 million people across a 5,000-square-mile travel area surrounding New York City, Long Island, southeastern New York State, and Connecticut. The MTA network comprises the nation’s largest bus fleet and more subway and commuter rail cars than all other U.S. transit systems combined. MTA strives to provide a safe and reliable commute, excellent customer service, and rewarding opportunities. 

  

ADDITIONAL INFORMATION 

  

Final salary is determined experience, skillset, and alignment with compensation practices. The posted range reflects expected compensation and may be updated as market or business needs evolve. 

  

To be eligible for consideration for a new role, current MTA employees must complete at least one year of service in their current role prior to applying. Additionally, eligibility to interview is contingent upon maintaining a satisfactory record of job performance, attendance, and disciplinary conduct. Pursuant to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must file an Annual Statement of Financial Disclosure (FDS) with the NYS Commission on Ethics and Lobbying in Government (the “Commission”). 

  

HOW TO APPLY 

  

Qualified applicants can submit an online application by clicking on the ‘APPLY NOW’ button from either the CAREERS page or from the JOB DESCRIPTION page. 

  

If you have previously applied online for other positions, enter your Username and Password.  If it is your first registration, click on the CLICK HERE TO REGISTER hyperlink and enter a Username and Password; then click on the REGISTER button.  

  

EQUAL EMPLOYMENT OPPORTUNITY 

  

MTA and its subsidiary and affiliated agencies are Equal Opportunity Employers, including with respect to veteran status and individuals with disabilities. 

The MTA encourages qualified applicants from diverse backgrounds, experiences, and abilities, including military service members, to apply.