Insurance Fraud Analyst I/II

Section:                                  Insurance Fraud Section/Criminal Law Division

Class:                                      Insurance Fraud Analyst I/II

Location:                                Harrisburg

Telework:                               This position will report to the headquartered location a minimum of 2 days per week.  You may have the opportunity to telework the remainder of the week, if desired and based on business need.   

Position Type:                       Full-Time, Non-civil service, Union

Work Hours:                          8:30 – 5:00      

Salary Range:                        Insurance Fraud Analyst I-Pay Range 5: Starting salary $41,917

                                                Insurance Fraud Analyst II-Pay Range 7: Starting salary $54,181

Basic Function

This position is entry level/intermediate technical work within the Insurance Fraud Section of the Office of Attorney General.  Work includes the receipt, analysis, verification, and dissemination of information of a confidential and sensitive nature for a variety of purposes including investigation and litigation support.  The successful candidate will work closely with criminal prosecutors to prepare court documents, organize trial exhibits, and attend court proceedings.  

The employee is responsible for performing analytical work involving referrals made to the Insurance Fraud Section, which may involve fraud and deception.  In this position, an employee may have contact with the public.  Assignments and supervision are received from the legal staff and/or investigative staff dependent on the nature of the case(s).  Work is reviewed in progress and upon completion to ensure accuracy and compliance with established office procedures and policy.

Assignments progress in difficulty and complexity, and are designed to provide experience in investigative analysis techniques and resources.  As an Insurance Fraud Analyst (IFA) I gains experience, work is performed with more independence.  An IFA II will complete most assignments independently with the supervisor providing a general outline of assignments, established priorities, and deadlines.   

An Insurance Fraud Analyst I could perform the below duties under the direction and guidance of an experienced analyst and/or supervisor.  An Insurance Fraud Analyst II could perform the below duties independently:

• Conducts initial review of referrals, and assists legal staff and investigative staff in case determination
• Organizes, maintains, and disseminates referral and investigative files digitally and in hardcopy as required
• Serves as the initial OAG contact with the referring party, either telephonically, electronically, or in person, and conducts the initial interview with said party in order to clarify any issues and to ensure that all required documents are provided
• Serves as the OAG liaison with the industry on selected and varied issues and problems that may arise, and serves as a source for responding to questions
• Provides assistance to agents relative to data checks, background checks, and claims histories
• Provides pre-operational planning assistance to agents with warrant executions
• Assists with the execution of search warrants for the purpose of cataloging data and documentary evidence
• Analyzes and transcribes toll records during criminal investigations
• Provides assistance to both legal and investigative staff regarding the analysis and organization of documentary evidence as well as the preparation of various spreadsheets, charts, and graphs pertinent to casework handled by the Section
• Prepares investigative reports on evidence and data analyzed
• Provides litigation support through preparation and presentation of material/evidence for official proceedings/court
• Testifies in court proceedings and grand jury proceedings regarding analytical findings
• Uses electronic data processing systems to research, analyze, and store data
• Performs miscellaneous, albeit pertinent duties, determined by the direction of current casework
• Presents analytical briefings, cases studies, and presentations on behalf of the OAG at conferences, seminars, and trainings
• Ascertains training needs of the industry with respect to OAG jurisdiction

Insurance Fraud Analyst I:

• A Bachelor’s Degree from an accredited institution OR
• Graduation from high school and four years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR
• Any equivalent combination of relevant education, training, and experience that would enable the individual to perform the duties of the job

Insurance Fraud Analyst II:

• A Bachelor’s Degree from an accredited institution and two years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR
• A Master’s Degree from an accredited institution in the criminal justice or related field OR
• Graduation from high school and six years of relevant experience that would afford the individual the needed knowledge and skills to perform the job OR
• Any equivalent combination of relevant education, training and experience that would enable the individual to perform the duties of the job