Senior Investigative Officer

Duties Description
The New York State Insurance Fund (NYSIF), Division of Confidential Investigations (DCI), is among the most active special investigations units in the country, working with local, state, and federal authorities in the investigation, arrest, indictment, and prosecution of individuals and businesses suspected of fraud involving NYSIF. DCI's mission is to reduce instances of insurance fraud and abuse against NYSIF and to prevent and mitigate fraud.

DCI is comprised of four separate units:
Claims Fraud, Provider Fraud, Premium Fraud, and Data Analytics.

Description

Duties Description
The New York State Insurance Fund (NYSIF), Division of Confidential Investigations (DCI), is among the most active special investigations units in the country, working with local, state, and federal authorities in the investigation, arrest, indictment, and prosecution of individuals and businesses suspected of fraud involving NYSIF. DCI's mission is to reduce instances of insurance fraud and abuse against NYSIF and to prevent and mitigate fraud.

DCI is comprised of four separate units:
Claims Fraud, Provider Fraud, Premium Fraud, and Data Analytics.
Reporting through the Fraud Team supervisory chain, the Senior Investigative Officer will serve as an experienced investigator responsible for conducting workers' compensation fraud investigations involving claimants throughout the state.
The Senior Investigative Officer handles confidential and sensitive matters, manages an assigned caseload, develops evidence, conducts surveillance and interviews, prepares investigative reports, and supports referrals to prosecutors, NYSIF Legal, and NYSIF civil attorneys. The position may provide peer support, onboarding assistance, or practical investigative guidance to less experienced investigators.
Responsibilities Include, But Are Not Limited To

• Manage an assigned investigative caseload involving suspected workers' compensation fraud, waste, and abuse by claimants, providers or policyholders throughout the state.
• Gather, review, and analyze documentary evidence from NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, policyholder records, and other sources relevant to the investigation.
• Conduct database and public-records research involving individuals, corporations, liens, addresses, property ownership, social media activity, and other relevant investigative leads.
• Plan and conduct investigative activities, including interviews, witness contact, affidavit development, and the collection of documentary evidence related to concealed employment or other suspected fraudulent activity.
• Use appropriate foot, stationary, and vehicle surveillance techniques to gather and preserve evidence at worksites, private residences, businesses, medical offices, and other relevant locations.
• Prepare clear, accurate, and well-supported investigative reports, surveillance summaries, evidence summaries, and referral packages for review by DCI leadership, prosecutors, NYSIF Legal, or NYSIF civil attorneys.
• Assist with case referrals and follow-up by responding to requests for additional information from prosecutors, NYSIF Legal, or agency stakeholders.
• Support legal proceedings when needed, including preparation for hearings, grand jury presentations, trials, Workers' Compensation Board proceedings, and testimony.
• Coordinate professionally with NYSIF departments, law enforcement partners, prosecutors, insurance fraud officials, and other external stakeholders as appropriate to support case development and fraud prevention.
• Apply knowledge of workers' compensation law, fraud indicators, investigative techniques, and evidentiary requirements to develop complete…