Fraud Investigator

Job Summary

Investigates special investigation unit claims; analyzes and documents potential fraudulent insurance claims. Applies complete knowledge, skills, and practices to perform assignments.

Job Description

What is the opportunity?

In this role as Fraud Investigator, you will gather, prepare and analyze documents and information relating to specific events, in an attempt to mitigate financial, reputational, regulatory and legal risk using established procedures and in accordance with RBC Insurance Policy. Shares responsibility for all components of investigations/fraud detection with peers and Managers of IIS. Ensures investigation work is accurate and up to date.

*This role has a Hybrid work model with 2 - 3 days in-office*

What will you do?

• Set up and triage of cases, as well as the ownership of tracking and reporting tools for cases and invoices.
• Gather and analyze documents in Insurance with a particular focus on loss prevention as well as intelligence gathering and identification of offenders.
• Investigate routine events with limited complexity.
• Update and maintain paper and electronic files ensuring accuracy, timeliness and thoroughness.
• Communicate to Managers and Director, fraud trends, issues, significant control weaknesses or deficiencies identified during investigations.
• Complete root cause analysis of your closed investigations and proactively enhance IIS policy and procedure in conjunction with Investigators.
• Assist in triaging and upfront analytics on identified claims, supporting investigations as required.
• Active participation in projects that enhance fraud detection in Insurance business.
• Develop and maintain a network of internal partners and external peers in the industry, police and other authorities to ensure a consistent approach to the detection and investigation of criminal activity against RBCI.

What do you need to succeed?

Must-have:

• A minimum of 3 years fraud analytics and/or medical fraud adjudication experience
• Effective and strong written and oral communication skills
• Good research, organizational and analytical skills
• Ability to lead by example through provision of knowledge, cooperation and teamwork.
• Skills in Microsoft Office computer applications
• Strong technical knowledge of Excel

Nice to have:

• University degree or equivalent experience
• Experience with gathering evidence
• Knowledge of RBC systems/processes an asset
• Bilingual (French & English speaking)

What’s in it for you?

We thrive on the challenge to be our best, progressive thinking to keep growing, and working together to deliver trusted advice to help our clients thrive and communities prosper. We care about each other, reaching our potential, making a difference to our communities, and achieving success that is mutual.

• A comprehensive Total Rewards Program including bonuses and flexible benefits, competitive compensation, commissions, and stock where applicable
• Leaders who support your development through coaching and managing opportunities
• Flexible work/life balance options
• Work in a dynamic, collaborative, progressive, and high-performing team
• Ability to make a difference and lasting impact

#TECHPJ
#LI-hybrid
#LI-post

Job Skills

Coverage Analysis, Detail-Oriented, Information Capture, Insurance Claims Investigations, Insurance Fraud Investigations, Interview Techniques, Liability Loss Control, Litigation Management, Risk Assessments, Vendor Management

Additional Job Details

Address: MEADOWVALE BUSINESS PARK, 6880 FINANCIAL DR:MISSISSAUGA

City: MISSISSAUGA

Country: Canada

Work hours/week: 37.5

Employment Type: Full time

Platform: GROUP RISK MANAGEMENT

Job Type: Regular

Pay Type: Salaried

Posted Date: 2025-03-28

Application Deadline: 2025-04-18

Note: Applications will be accepted until 11:59 PM on the day prior to the application deadline date above

Inclusion and Equal Opportunity Employment

At RBC, we believe an inclusive workplace that has diverse perspectives is core to our continued growth as one of the largest and most successful banks in the world. Maintaining a workplace where our employees feel supported to perform at their best, effectively collaborate, drive innovation, and grow professionally helps to bring our Purpose to life and create value for our clients and communities. RBC strives to deliver this through policies and programs intended to foster a workplace based on respect, belonging and opportunity for all.

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