| Claims Investigation Director Job Description |
 |
| The following is a full job description for Claims Investigation Director. Here are the requirements and responsibilities for Claims Investigation Director along with statistics. If after reading this page you determine that Claims Investigation Director is not the position you are looking for, you may want to try one of these similar titles: VP of Claims, Claims Manager, Fraud Investigation Manager, Claims Manager, Senior, Disability Claims Examiner III, Claims Examiner I, Claims Examiner II, Claims Examiner III, Claims Examiner IV |
|
| Requirements and Responsibilities For Claims Investigation Director |
| Directs the claims investigation function to detect, investigate, and prevent fraudulent or suspicious claims activity. Oversees managers and investigators responsible for special investigations, surveillance, and fraud analysis. Develops investigation strategy, protocols, and standards aligned with legal and regulatory requirements. Analyzes fraud trends and investigative outcomes to inform prevention and recovery initiatives. Coordinates with legal counsel, law enforcement, and regulatory agencies on significant cases. Ensures compliance with applicable laws, regulations, and ethical investigative standards. Requires a bachelor's degree. Typically reports to senior management. Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. |
| |
|
| Also referred to as: Claim Compliance Investigation Director, Insurance Compliance Investigation Director, Insurance Fraud Investigation Director, Suspicious Claims Investigation Director |
|
| Similar Jobs: VP of Claims, Claims Manager, Fraud Investigation Manager, Claims Manager, Senior, Disability Claims Examiner III, Claims Examiner I, Claims Examiner II, Claims Examiner III, Claims Examiner IV |
|
| Level of Education: Claims Investigation Director Salaries with No Diploma, Claims Investigation Director Salaries with a High School Diploma or Technical Certificate, Claims Investigation Director Salaries with an Associate's Degree, Claims Investigation Director Salaries with a Bachelor's Degree, Claims Investigation Director Salaries with a Master's Degree or MBA, Claims Investigation Director Salaries with a JD, MD, PhD or Equivalent |
|
|
| Industries: Aerospace & Defense, Biotechnology, Business Services, Chemicals, Construction, Edu., Gov't. & Nonprofit, Energy & Utilities, Financial Services, Healthcare, Hospitality & Leisure, Insurance, Internet, Media, MFG Durable, MFG Nondurable, Pharmaceuticals, Retail & Wholesale, Software & Networking, Telecom, Transportation | |
