Career Development

What Does a Fraud Examiner Do?

Find out what a fraud examiner does, how to get this job, and what it takes to succeed as a fraud examiner.

Fraud examiners are responsible for investigating cases of fraud and other financial crimes. They commonly work for insurance companies, banks, or government agencies, but they may also be employed by private investigation firms or consulting companies.

Fraud examiners typically begin an investigation by reviewing documentation related to a claim or suspicion of fraud. This might include statements from witnesses, police reports, medical records, etc. From there, they’ll likely conduct interviews with relevant parties and analyze any physical evidence that has been collected.

Fraud Examiner Job Duties

Fraud examiners have a wide range of responsibilities, which can include:

  • Conducting interviews with employees to determine whether they have knowledge of fraud activities, including bribery or embezzlement
  • Reviewing financial statements and other documents to detect irregularities in order to identify potential fraud cases
  • Interviewing potential suspects in an investigation, including questioning them about details surrounding the alleged fraud
  • Analyzing financial data to identify patterns of fraud that may be missed by untrained eyes
  • Interviewing witnesses and suspects in order to obtain information related to the case
  • Preparing detailed reports of findings and conclusions after an investigation is complete
  • Preparing case files for submission to magistrate or grand jury for indictment of suspects
  • Interviewing victims of fraud or theft to determine how much money was lost as a result of the crime
  • Working with insurance companies to investigate claims of fraud involving fire or natural disaster damage to property

Fraud Examiner Salary & Outlook

Fraud examiners’ salaries vary depending on their level of education, years of experience, and the company size and location. They may also earn additional compensation in the form of bonuses.

  • Median Annual Salary: $72,500 ($34.86/hour)
  • Top 10% Annual Salary: $275,000 ($132.21/hour)

The employment of fraud examiners is expected to grow faster than average over the next decade.

Demand for these workers is expected to increase as organizations hire more fraud examiners to help prevent and detect employee and customer fraud. Organizations will want to hire more fraud examiners to ensure that they are complying with laws and regulations governing financial reporting and payment processing.

Fraud Examiner Job Requirements

To become a fraud examiner, you will likely need to have the following:

Education: Fraud examiners are typically required to have a bachelor’s degree in criminal justice, accounting, finance or another closely related field. Some employers prefer candidates who have a master’s degree in accounting or fraud examination.

Training & Experience: Most fraud examiners receive on-the-job training to learn the specific processes and procedures of their role. This training may last for a few weeks or months, depending on the company’s size and the complexity of the role.

Certifications & Licenses: Many employers require fraud examiners to have certification. Whether you choose to pursue a certification is up to you, but employers may expect it.

Fraud Examiner Skills

Fraud examiners need the following skills in order to be successful:

Communication Skills: Fraud examiners must be able to communicate effectively with all levels of an organization, from the C-suite to the front line employees. They also need to be able to build relationships with law enforcement and other organizations that can help them investigate fraud.

Critical Thinking Skills: Investigating a fraud requires looking at data from multiple angles to find discrepancies. Fraud examiners must be able to think critically and ask the right questions in order to get to the bottom of a fraud scheme.

Research Skills: Fraud examiners must be able to research quickly and efficiently, gathering data from a variety of sources in order to build a complete picture of what has happened.

Computer Skills: Most of the work of a fraud examiner is done on a computer, so they must be proficient in using computers for research, data analysis, and communicating with others.

Time Management Skills: Fraud investigations can take time, so fraud examiners must be able to manage their time effectively so that they can stay on top of all the different aspects of an investigation.

Fraud Examiner Work Environment

Fraud examiners work in a variety of settings, including corporate offices, banks, and government agencies. They typically work a standard 40-hour week, but they may have to work longer hours to complete investigations or to meet deadlines. Some fraud examiners travel to different locations to conduct on-site investigations. The work can be stressful, and fraud examiners must be able to handle the pressure of working on complex cases. They must also be able to maintain the confidentiality of their work.

Fraud Examiner Trends

Here are three trends influencing how fraud examiners work. Fraud examiners will need to stay up-to-date on these developments to keep their skills relevant and maintain a competitive advantage in the workplace.

The Growth of Digital Commerce

The growth of digital commerce is changing the way that businesses operate, and this is having a significant impact on the insurance industry. As more and more transactions take place online, insurers need to be able to detect and prevent fraud in order to protect their bottom line.

This is where fraud examiners come in. They are responsible for identifying fraudulent claims and preventing them from being paid out. In order to do this effectively, they need to be familiar with the latest trends in digital commerce, such as the use of cryptocurrencies and online payments.

More Focus on Cybersecurity

As businesses become increasingly reliant on technology, the need for cybersecurity professionals will continue to grow. Fraud examiners can capitalize on this trend by becoming experts in cybersecurity and developing skills that are in high demand.

By focusing on cybersecurity, fraud examiners can help businesses protect themselves against cyberattacks and reduce the risk of data breaches. In addition, fraud examiners can also focus on educating employees about how to stay safe online.

Greater Use of Data Analytics

Data analytics is becoming an increasingly important tool for businesses looking to improve their operations. This is especially true for companies in the insurance industry, which rely on accurate data to make informed decisions about policy pricing and coverage.

Fraud examiners can utilize data analytics to identify patterns in claims data that may indicate fraudulent activity. By doing so, they can help ensure that insurance companies are paying only for legitimate claims.

How to Become a Fraud Examiner

A fraud examiner career path can be rewarding and lucrative. It’s important to start off on the right foot by getting certified in your field. There are many different certifications available, so choose one that is relevant to your area of expertise.

Once you have your certification, it’s time to get out there and network with other professionals in your field. Attend industry events and stay up-to-date on the latest trends in fraud prevention. This will help you stand out from the crowd when applying for jobs.

When looking for a job, make sure you target companies that specialize in fraud prevention. These companies often offer great benefits and opportunities for growth.

Advancement Prospects

Fraud examiners who are employed by organizations may advance to management positions within their company. Some fraud examiners may also become consultants, working for themselves. As a consultant, a fraud examiner may have more control over the types of cases they work on and the hours they work. In addition, consultants are typically paid more than employees for their services.

Fraud Examiner Job Description Example

At [CompanyX], we are committed to providing the highest level of customer service. Part of that commitment is ensuring the security of our customers’ information. We are looking for a qualified fraud examiner to join our team and help us protect our customers from fraud and identity theft. The ideal candidate will have experience conducting investigations, analyzing data, and writing reports. He or she will be able to work independently and be detail-oriented. The fraud examiner will be responsible for identifying, investigating, and preventing fraud and identity theft.

Duties & Responsibilities

  • Conduct in-depth analysis of financial records to detect fraudulent activity
  • Identify and investigate potential instances of fraud, waste, or abuse
  • Gather evidence and compile information to be used in court proceedings
  • Prepare detailed reports outlining findings and present results to law enforcement officials and/or company management
  • Stay up-to-date on changes in laws and regulations related to fraud examination
  • Keep abreast of new developments in the field of forensic accounting and fraud detection
  • Develop and implement policies and procedures designed to prevent and deter fraud
  • Train staff on how to identify and report instances of fraud
  • Serve as an expert witness in court proceedings related to fraud cases
  • Assist in the development of computer-based tools and systems for fraud detection and prevention
  • Conduct research on new methods of fraud detection
  • Maintain knowledge of current trends in fraud

Required Skills and Qualifications

  • Bachelor’s degree in accounting, finance, or related field
  • 3-5 years of experience working in fraud examination or a related role
  • CFE certification preferred
  • Proficient in Microsoft Office, with advanced Excel skills
  • Excellent analytical and problem-solving skills
  • Strong attention to detail
  • Ability to work independently and meet deadlines

Preferred Skills and Qualifications

  • Masters degree in accounting, finance, or related field
  • CPA or CIA certification
  • Experience with data analysis software, such as ACL or IDEA
  • Familiarity with SQL
  • Knowledge of anti-money laundering regulations

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