HYBRID- Insurance Investigation Officer 2

About Us:

The Ohio Department of Insurance (ODI) was established in 1872 as an agency charged with overseeing insurance regulations, enforcing statutes mandating consumer protections, educating consumers, and fostering the stability of insurance markets in Ohio.

Today, the mission of the Ohio Department of Insurance is to provide consumer protection through education and fair but vigilant regulation while promoting a stable and competitive environment for insurers.

Please visit our website Department of Insurance and also find us on LinkedIn.

The Role of the ODI Fraud & Enforcement Division:

The Agency’s Fraud & Enforcement Division was established to ensure all Ohio insurance laws are abided by and enforced. The Division is responsible for conducting administrative and criminal investigations related to unauthorized insurance transactions, agent misconduct and insurance fraud.

The Fraud & Enforcement Division is seeking a creative, self-motivated professional with a strong work ethic to fill an Insurance Investigation Officer 2 position within its Fraud Unit. The person who fills this position will specifically be responsible for conducting criminal investigations into allegations of healthcare fraud.

If this sounds interesting to you, continue reading below to learn more about the career opportunity with our Department!

What You'll Do:

As an Insurance Investigation Officer 2 within the Fraud Unit, your key responsibilities would include, but not be limited to:

• Analyzing allegations of insurance fraud and crimes related to insurance.
• Conducting criminal investigations related to violations of Title 29 and Title 39 of the Ohio Revised Code.
• Assisting or conducting joint investigations with local, state and/or federal law enforcement agencies.
• Gathering information, documents and/or evidence, using a wide variety of techniques.
• Interviewing complainants, suspects, witnesses, insurance company representatives, policyholders, medical providers, employers, etc.
• Preparing investigative reports documenting the outcome of investigations conducted
• Referring investigative findings to local, state and/or federal prosecutors.
• Testifying during criminal proceedings.
• Representing the division during industry or law enforcement meetings and conferences.
• Performing other duties as assigned.

What’s in it for you:

Unless required by legislation or union contract, the final candidate can expect to be paid at the lowest step in the pay range (step 1). As an Insurance Investigation Officer 2, you will receive a raise after six (6) months and yearly step increases until you reach the top level of the pay range. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.

This position is designated as telework eligible. The agency has a hybrid work model which allows employees to work from home but also requires in-person attendance in the office based on operational need. As such, successful candidates must have and maintain internet at their remote location during normal working hours. In addition, employees must reside in Ohio and within a reasonable distance from the Department location to respond to workplace reporting requirements.

At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website!

Completion of undergraduate core program in business, insurance or criminal justice; 2 yrs. exp. in insurance or insurance related entity (e.g., sales; marketing; claims adjuster; investigations); 9 mos. exp. or 9 mos. trg. in operation of computer terminal &/or personal computer.

• Or 4 yrs. exp. in insurance field or insurance related entity (e.g., sales; marketing; claims adjuster; investigations); 9 mos. exp. or 9 mos. trg. in operation of computer terminal &/or personal computer.

• Or 4 yrs. exp. in law enforcement which included 3 yrs. exp. in conducting investigations; 9 mos. exp. or 9 mos. trg. In operation of computer terminal &/or personal computer.

• Or 24 mos. exp. as Insurance Investigation Officer 1, 26271, with experience corresponding to type of complaints & alleged violations appearing in job posting/approved job description.

• Or equivalent of Minimum Class Qualifications for Employment noted above.

NOTE: UNUSUAL WORKING CONDITIONS

Travel required; may be exposed to hostile or violent persons.

Knowledge of state insurance laws & administrative codes regulating all types of insurance coverage*; divisional policy & procedures operating manual*; applicable Ohio Revised Codes (e.g., Title 29; Title 39)*; investigative principles/techniques; interviewing; public relations; adjudicative &/or criminal legal proceedings*; U.S. Title 13 (i.e., mail fraud statutes)*; Leads Enforcement Data System (i.e., LEADS) Administrative Rules*. Skill in operation of computer terminal &/or personal computer; word processor*; typewriter*; copier*. Ability to define problems, collect data, establish facts & draw valid conclusions; prepare accurate & concise investigation reports; gather data & prepare necessary documentation for administrative hearings &/or referral of cases to various county prosecutors or state/federal authorities; handle routine & sensitive inquiries from & contacts with legal & law enforcement personnel, general public, insurance company representatives & local, state &/or federal government employees.

Application Procedures:

All applicants must submit a completed Ohio Civil Service Application and clearly indicate how they meet the minimum qualifications and/or position specific minimum qualifications. Applicants are also encouraged to document in detail any experience, education and/or training related to the job duties of the positions(s) applying for. All answers to the supplemental questions MUST be supported by the work experience/education provided on your civil service application. Attachments to your application are not accepted for this job posting. In order to be considered for this position, you must apply on-line. Paper applications WILL NOT be accepted.

Educational Transcripts:

Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript if selected for an interview. Failure to provide the transcript at the time of the interview will cause the applicant to be eliminated from further consideration.

Status of Posted Positions:

You can check the status of your application online by signing in to your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details. Questions about the position not pertaining to your application status can be directed to: Kim Lowry @ 614-644-2681.

**Correspondence regarding your application will be sent to the email address provided on your application.**

Applicants must be currently authorized to work in the United States on a full-time basis.

Reasonable Accommodation: ODI is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs, and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. To request a reasonable accommodation due to a disability please the agency Human Resource Offices’ ADA Coordinator, Andrew Skal, by emailing Andrew.Skal@insurance.ohio.gov or calling 614-644-3264 or TTY 711(then dial) 614-644-3264 no later than a minimum of fourteen (14) days before a hiring event, for example, a structured interview.

The final candidate selected for the position will be required to undergo a criminal background check. Section 2961 of the Ohio Revised (ORC) prohibits individuals convicted of a felony involving fraud, deceit, or theft from holding a position that has substantial management of control over property of a state agency.