Fraud Investigator Resume Samples

The job description of a Fraud Investigator includes investigating various kinds of frauds in various types of organization which can relate to monetary issues, legal claims, work injuries, forgeries, accidents, or non-monetary frauds. The Fraud Investigator Resume describes the following core tasks and duties – conducting a thorough, unbiased and fair investigation, reviewing and researching evidence, preparing and coordinating field assignments, coordinating with defense attorneys, managing varied caseloads, preparing prosecution packages or restitution proposals; performing surveillance work and ascertaining background information regarding claimants.

While the setting of the job may vary, the skill sets are universally common and include the following – ingenuity and persistence, the ability to interact with upper management, clients and law enforcement; strong grasp over governing law, hands-on experience with relevant information systems, and good interrogation skills. A degree pertaining to fields such as Criminal justice, insurance studies, or risk management is commonly seen on resumes.

Fraud Investigator Resume

Objective : A customer service representative with Financial Sales and technical background seeking employment in an Inbound Rep role where utilizing a vast array of skills and building on the experiences of a diverse background will help move forward and continue the excellent work of the organization.

Skills : microsoft office, Excel, LexisNexis, Credit Browser.

Description :

    1. Handled credit, debit, and prepaid accounts with potential fraudulent activity on a day to day.
    2. Processing credit applications needed undivided attention and judgement was highly important.
    3. One of the main goals were to work independently and effectively.
    4. Certain things that threw red flags in regards to potential fraudulent activity would be recently opened credit lines with a falsified credit report.
    5. Reviewed documents that pertained to the customer and tried to bypass mistreating the actual customer while preventing the posing customer from drastically ruining the actual customer's credit information.
    6. About half way through the year, Barclays offered me the position of Facilitator but I respectfully declined.
    7. Facilitators are Leads that are trained to be Operations Managers.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Diploma


Client Fraud Investigator Resume

Objective : Customer Service | Underwriter | Fraud investigator Proven experience in client services, underwriting, and investigations. Excellent communication and people skills, results oriented. Comfortable working independently as well as in a team environment. Seeking to obtain a prominent position that will exemplify my experience, organizational skills, and my dependability as an employee and as a person, so that I will be an asset to your team.

Skills : Great Communication Skills, Strong Leadership Abilities, Self Motivated, Problem Solving Abilities, Fraud Detection, Quality Management.

Description :

    1. Responsible for functions related to the identification, prevention, and resolution of fraudulent activity including review of new accounts, unusual client transactions, check and deposit fraud, card fraud, signature verification, loan applications and online fraud.
    2. Identify research and analyze possible fraudulent activity on client accounts and process client fraud claims.
    3. Monitor reports and systems which identify potential fraudulent activity.
    4. Analyze client accounts, applications, and transactions to detect fraud and take appropriate action.
    5. Assess levels of possible risk and communicate trends and patterns to management.
    6. Develop successful training programs and manuals for growth strategies.
    7. Present suggestions for procedural changes to management.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Junior
Education
Education
Certificate In Counseling


Tele - Fraud Investigator Resume

Summary : Proven experience in client services, underwriting, and investigations. Excellent communication and people skills, results oriented. Comfortable working independently as well as in a team environment. Seeking to obtain a prominent position that will exemplify my experience, organizational skills, and my dependability as an employee and as a person, so that I will be an asset to your team.

Skills : Certified Health Care Anti-Fraud Associate.

Description :

    1. Responsible for conducting investigations when a fraudulent insurance act is suspected or has been committed, such as billing for a service that was never rendered, the duplicate submission of a claim for the same service and misrepresenting the services provided.
    2. Detection and reporting of cases in compliance with the requirements of CMS, State and Federal regulations.
    3. Medical record review with clinical team (RN & Medical Director) Implementation of strategies and tools to prevent, detect, investigate and report Fraud and Abuse as it relates to members, providers, vendors, and employees.
    4. Evaluate business operations to identify risk areas for fraud.
    5. Prepares summary and/or detailed reports on investigative findings and/or referrals to state and federal agencies to include, but not limited to, the MEDIC, FBI, Attorney General MFCU, HHS-OIG, MDCH, ODJFS, CMS and local law enforcement.
    6. Conduct interviews, compile documentation and evidence, and maintain investigative reports.
    7. Perform case analysis and support documentation for farther legal actions or administrative actions.
    8. Review Contracts and Notify the Market that an investigation is being conducted.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Associates

Insurance Fraud Investigator Resume

Objective : Risk Management Professional skilled at identifying complex issues and developing cost effective solutions for a Fortune 500 company. Extensive background in mortgage lending, fraud prevention, auditing, compliance review, and loss mitigation. Major strengths in leadership, communication, and project management. An innovative, energetic and proactive professional with vision as well as the ability to adapt to change as business needs dictate.

Skills : Certified Health Care Anti-Fraud Associate.

Description :

    1. Conducted mortgage fraud investigations and quality control audits.
    2. Developed tools and controls to reduce the risk of loss due to fraud, regulatory compliance, and quality issues.
    3. Performed numerous high profile investigations involving high dollar losses and assisted Recourse Operations unit's efforts to have problem loans repurchased by client lenders.
    4. Designed and implemented fraud detection and prevention processes that reduced HSBC's loss exposure by 50% on mortgage portfolios purchased from other lenders.
    5. Supervised the implementation of a loan auditing process that reviewed loans for compliance and underwriting issues.
    6. Identified $6 million in losses that were recovered from original lender.
    7. Coordinated the team's efforts on multiple projects.
    8. Planned, prioritized, and assigned caseloads to ensure deadlines were met and a high level of quality maintained.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Masters Of Business Administration

Fraud Investigator/Customer Service Resume

Summary : A proven team leader in customer service and network support with over 7 years experience in the telecommunications industry, I have a proven track record of meeting deadlines without sacrificing customer service or quality. Effectively working with all levels of internal and external teams with little direction from management to achieve company objectives, I have proven myself to be results-oriented with a focus on the bottom line.

Skills : Skills Proficient in Microsoft Office including Word, Excel, PowerPoint and Access Strong time management, follow through, and organizational skills Excellent verbal and written communication skills. Strong time management and interpersonal skills.

Description :

    1. Communicated and worked with Corporate Security and law enforcement to report fraud.
    2. Advised corporate and high net-worth individual clients in regard to their account security.
    3. Identified, prevented and resolved fraudulent account activities including review of new online accounts.
    4. Monitored new accounts and phases for fraudulent transactions.
    5. Reviewed reports and systems to identify potential fraud.
    6. Assisted with fraud incidents within the network of the bank.
    7. Prepared various fraud documents including Suspicious Activity Reports.
    8. Limit potential loss exposure by placing holds on accounts and or card status to limit funds availability.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Business Administration

Fraud Investigator/Risk Analyst Resume

Objective : Over fifteen years experience in conducting various investigations, involving individuals, families and organized groups alleged and to be attempting or committing fraudulent acts against social service programs/funds.

Skills : Collections, Skip Tracing, Data Entry, Risk Management, Training, Benefits Consultant, Customer Service, Accounts Receivable, Fraud Analyst, Administrative Assistant.

Description :

    1. Performed investigations specific to the defense of insurance claims related to worker's compensation, motor vehicle accidents, liability cases, and general liability cases.
    2. Utilized Internet Mining/Social Media Investigations.
    3. Completed Due Diligence, Claimant Profile, and Database Investigations Executed background checks, locate services, medical canvasses, and subject activity checks.
    4. Maintained Florida CC Private Investigators license.
    5. Command Investigations - Fraud Investigator Provided and maintained covert investigations, case documentation via video upload, and comprehensive written reports of the targeted subject's day to day activities.
    6. Performed investigations specific to the defense of insurance claims primarily related to worker's compensation.
    7. Utilized online information search, online database research, assists in claims fraud analysis Completed accident scene investigations, collection of evidence, video and picture documentation, as well as evidence analysis.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Ultimate Medical

Fraud Investigator I Resume

Objective : Cross-functional, multi-talented professional with progressive experience in: fraud investigations, risk assessment, security solutions, project management, operations and policy implementation within the banking and financial services industry. Skills include: administrative/operations management, budgeting, financial securities protection and key leadership to produce process improvements and deliver efficiencies to support scalable growth plans.

Skills : Microsoft Office.

Description :

    1. Focused primarily on credit card fraud and convenience check fraud.
    2. Served as primary contact for money laundering and check-kiting cases for bank personnel and law enforcement.
    3. Interfaced with Visa and MasterCard organizations to process chargebacks on relevant accounts.
    4. Directed loss mitigation recovery efforts to guarantee all possible opportunities were accounted for.
    5. Maintained positive relations between affected customers and bank by expressing support and appropriate sentiment while concurrently working with them to ascertain circumstances.
    6. Maintained monthly recovery rate of over 92%.
    7. Managed 400-600 cases per month while personally sustaining recovery-rate above departmental standards.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Junior
Education
Education
Associates In Liberal Arts

Fraud Investigator II Resume

Headline : Searching for employment opportunities in a fast paced environment. With my skill set in providing the customer with a superior customer experience and specializing in Retention, Sales and Account Management, i feel that i can be an asset to any company.

Skills : Microsoft Office.

Description :

    1. Conduct background investigation of claimant to obtain data on character, financial status, and personal history.
    2. Finding creative methods in locating missing persons, obtain confidential information, and solve crimes from skip tracing software.
    3. Performing undercover assignments and surveillance, and authorized wiretaps.
    4. Preparing reports that detail investigation findings.
    5. Developed relationships with informants in order to obtain information related to cases.
    6. Conduct surveillance of suspects using binoculars and cameras.
    7. Testified in over 50 fraud cases at federal courts.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Law And Justice

Fraud Investigator Specialist Resume

Objective : Obtain a position in which my interpersonal, professional, and organizational skills will afford me the opportunity to make a unique and beneficial impact on the workplace. Specifically, I look to garner employment within a company in which my motivation, dedication to communication, and work ethic will provide me with the opportunity to grow as a professional and contribute to the success of the company and all its stakeholders.

Skills : Microsoft Office Suite ADT, Pacom Alarm Systems, Aperio,.

Description :

    1. Effectively and efficiently investigated fraud claims made by card members.
    2. Coordinated the preparation and filing of federal reports in congruence with legal requirements.
    3. Charged with drafting the legal documents that needed to be transmitted to card members in accordance with law.
    4. Communicated on a regular basis with other bank and legal institutions in an effort to confirm statements made by card members.
    5. Compared signatures on affidavits sent by card members to available documents the bank had on file.
    6. Responsible for making the final decision on the fraud investigation and communicated that outcome to card members in response to their initial claim.
    7. Worked cooperatively with card holders to establish payment plans and processed monetary repayment.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Michigan State Insurance Training

Health Care Fraud Investigator Resume

Headline : A proven background in Collections, Customer Service,and SkipTracer. Accustomed to working in fast paced environments with ability to think quickly and successfully handle difficult customers/clients This experience is further complemented with excellent interpersonal skills, oral and written communication, and the ability to work well with others in both supervisory or support staff roles.

Skills : Microsoft Office.

Description :

    1. Under direct supervision, conduct timely investigations on suspected and/or known fraudulent accounts.
    2. Make or receive calls from customers, Store Associates, and various aw enforcement agencies.
    3. Collaborate with various levels of loss prevention and law enforcement.
    4. Document accurate fraudulent case activity and provide timely updates to management.
    5. Correspond with various circuit courts pertaining to restitution.
    6. Create and maintain all reporting excel spreadsheets.
    7. Serve as a resource to Associates and have the ability to take on additional responsibilities.
    8. Meet with law enforcement and circuit court representatives when necessary.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Consultant
Education
Education
Bachelor Of Science

Fraud Investigator Resume

Headline : Obtain a position in which my interpersonal, professional, and organizational skills will afford me the opportunity to make a unique and beneficial impact on the workplace. Specifically, I look to garner employment within a company in which my motivation, dedication to communication, and work ethic will provide me with the opportunity to grow as a professional and contribute to the success of the company and all its stakeholders.

Skills : Microsoft excel, Microsoft Word,Microsoft Office Tools, Windows, Notary Public.

Description :

    1. Research system issues related to SQL created reports.
    2. Investigated first party fraud incidents against HSBC.
    3. Researched merchants through the Internet to verify company legitimacy.
    4. Communicated with other banks researching ownership of checking accounts being used to pay HSBC.
    5. Investigated incidents of identity theft using tools like Lexis Nexis.
    6. Processed written, email and telephone inquiries from fraud victims and perpetrators in both English and Spanish.
    7. Filed suspicious activity reports (SAR) to appropriate Federal and State agencies.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Diploma