Skills of a Fraud Investigator
Fraud investigators work for organizations that are targeted by scams from insiders and outsiders, such as insurance and financial services companies and government benefit units. They also work for federal, state and local law enforcement to investigate claims of fraud. Investigators use a variety of tools, such as background checks and eyewitness interviews, to help determine whether a fraud has occurred. Communication, attention to detail, the ability to think strategically and to learn are key skills for fraud investigators.
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Communication
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According to the Bureau of Labor Statistics, insurance companies prefer to hire fraud investigators who have a background in law enforcement or the insurance industry, as these individuals tend to have well-developed interviewing skills. Other critical communication skills include the ability to listen, to interrogate when necessary, and to demonstrate persistence and assertiveness in the face of reluctant witnesses.
Another critical aspect of communication for fraud investigators includes the ability to think quickly in the midst of an interview or interrogation, to alter the course of questioning and gather new information.
Attention to Detail
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Fraud investigators must be able to absorb small bits of data in written reports, through observation when visiting the site of a suspected fraud, and when interviewing witnesses and suspects. In many fraud investigations, it is the small pieces of information that will eventually fit together to provide a picture of how the fraud was committed, and by whom.
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Strategic Thinking
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Fraud investigators must draw together different pieces of information from a variety of sources to determine if a fraudulent act has been committed. To do so, they need the ability to think strategically, to see how small elements feed into the big picture. They also need to think strategically when planning interviews and interrogations to ensure that questions flow in a way that maximizes the amount of information gathered.
Learning
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Because federal and state laws impact fraud cases and are constantly evolving, fraud investigators must regularly update their knowledge of case law and outcomes. Fraud investigators in the medical insurance industry also need to be familiar with changes in how medication is prescribed and how medical procedures are used.
Many companies offer their employees training sessions relevant to changes in their industry, and external bodies offer certification and training in fraud investigation. The Certified Fraud Examiner (CFE) credential is a widely recognized accreditation for fraud examiners, as is the Certified Public Accountant (CPA) license. Continuing education requirements are in place for both the CFE and the CPA, requiring that holders receive training on an annual basis from programs such as the Department of Homeland Security’s course in procurement fraud.
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