Investigative Officer 1 (SIF)

NYSIF (Division of Confidential Investigations – Albany)

Salary: $53,826 - $68,511

Description:

NYSIF is looking for an Investigative Officer to support its Division of Confidential Investigations. The Investigative Officer will supervise extensive investigations of fraud, waste and abuse by claimants, policyholders and medical care providers throughout the state. Responsibilities include, but are not limited to:

• Gathers and analyzes critical documentary evidence from various department files, contracts, investigator reports, police reports, payroll records, business records, bank records, and policyholder books and reports.
• Utilizes strong investigative experience to handle a full range of investigative tasks, including the most complex and sensitive investigations which require a full understanding of workers’ compensation law.
• Personally supervises and/or conducts database searches into corporations, liens, address and property ownership, and gathers other such public and private intelligence information to support investigations.
• Utilizes investigative expertise and contacts within the legal/prosecutorial community to effectively investigate, gather and analyze critical documentary evidence to build a sound case. Reviews investigations, written reports and associated evidence to conclude sufficiency of evidence for presentation to a prosecutor for criminal actions or NYSIF Civil actions.
• Under the direction of the Investigative Officer 2 (SIF), uses their experience and knowledge of, and contacts with, prosecutorial officials to ensure the proper presentation of evidence and the full development of all potential criminal and civil actions. Investigative Officers 1 (SIF) may also directly ensure NYSIF’s investigations are receiving the proper attention from the prosecutors and provide assistance with the initiation and presentation of new cases, as well as the follow-up after convictions.
• Participates in NYSIF sponsored training to adapt investigative skills for the detection of insurance fraud.
• Provides fraud detection training and mentoring to Business Office staff to ensure optimal attention to potential signs or “Red Flags” of claims fraud, policy fraud and medical provider fraud. Interacts with all levels of staff and management at NYSIF in this regard.
• Reviews, analyzes and extracts material from claims, underwriting and hospital records to determine the validity of allegations.
• Interviews and obtains affidavits and testimonies from witnesses and subjects of investigations, including for example employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators and insurance executives.
• Obtains documentary evidence concerning concealed employment and illicit activities including payroll records, receipts, contracts, and affidavits from employers.
• Employs foot, stationary, and vehicle surveillance techniques to gather and record evidence in various formats.
• Directs undercover surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders utilizing the services of contractual investigators, as needed.
• Prepares narrative reports, as well as reviews and compiles staffs’ reports for submission to Executive Management.
• Maintains professional contact with Legal counsel, law enforcement authorities, sister state agencies and regulatory agencies.
• Collaborates with NYSIF attorneys on the preparation for trials, civil litigation and/or Workers’ Compensation Board hearings.
• Testifies at trials and other official proceedings, when necessary, and/or arranges for witness testimony and introduction of evidence at trial.
• May conduct internal employee background investigations.
• Prioritizes, assigns and coordinates the workload of support staff; providing training and advice to staff; and evaluating performance and quality of work.
• Employs appropriate techniques for handling sensitive, confidential and protected information.

Basic Qualifications: An associate’s degree or higher in criminal justice or related field, or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance related matters. Related fields include: law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management.

Primary Location: Albany

Travel: Some travel required

Schedule: Monday - Friday

Please note the following New York State Civil Service employment information:

• Jurisdictional classification: Non-competitive
• Bargaining unit: PEF

The New York State Insurance Fund (NYSIF) was established in 1914 as part of the original enactment of the New York State Workers’ Compensation Law. NYSIF's mission is to guarantee the availability of workers’ compensation insurance at the lowest possible cost to New York employers and to provide timely, appropriate indemnity and medical payments to injured workers, while maintaining a solvent fund. Since inception, NYSIF has fulfilled the dual roles for which it was created: to compete with other carriers to ensure a fair marketplace and to be a guaranteed source of coverage for employers who cannot secure coverage elsewhere.

NYSIF is the largest workers’ compensation carrier in New York State and among the top 10 largest workers’ compensation carriers in the nation, insuring approximately 139,000 policyholders, with more than $1.8 billion in annual earned premium and over $22 billion in assets. A self-supporting insurance carrier, NYSIF operates without taxpayer funding.

In addition to workers’ compensation insurance, NYSIF provides disability benefits coverage for off-the-job injuries to more than 56,000 New York employers. In 2018, NYSIF added paid family leave as a component of its disability benefits product, providing New Yorkers with job-protected, paid time away from work to care for their families.

Job Type: Full-time

Pay: $53,826.00 - $68,511.00 per year

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Albany, NY 12206: Reliably commute or planning to relocate before starting work (Required)

Work Location: Hybrid remote in Albany, NY 12206

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