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Summary of Job Description: The Senior Special Investigator performs investigations over a broad geographical area, investigating and mitigating workers' compensation fraud, abusive claims, and other related misconduct on behalf of the PRG Risk Management program under the oversight of the Manager, Special Investigations. The Senior Investigator conducts complex investigations, analyzes data for fraud indicators, and provides actionable recommendations to reduce exposure and enhance claims integrity. Job Responsibilities:
- Performs complex investigations that support the PRG Risk Management program by investigating and mitigating workers' compensation fraud, abusive claims, and other related misconduct under the oversight of the Manager, Special Investigations.
- Conducts face to face or telephonic interviews with associates and guests as a component of the investigation.
- Plans and executes complex investigations over a broad geographic area involving suspected workers' compensation and insurance fraud and evaluates potentially fraudulent activities, including falsified documents.
- Presents findings in comprehensive reports to support claim denial or mitigation strategies.
- Communicates with external investigators and the legal teamsand collaborates with their manager and peers on case strategies.
- Utilizes data mining and social media analysis tools to identify inconsistencies and recommend targeted surveillance.Conducts AOE/COE (Arising Out of Employment/Course of Employment) investigations and analysis to determine claim validity.
- Prepares and refers cases of suspected fraud to legal authorities under the supervision of their manager, including local District Attorneys and state fraud divisions.
- Testifies in legal or administrative proceedings, including Workers' Compensation Appeals Boards.
- Conducts and/or participates in fraud awareness training for staff and management as needed.
- Assists with guest issues on occasion, providing support for risk management-related incidents.
- Supports the company's policies to reduce claims fraud and abuse.
- Ensures investigations are in compliance with all applicable safety and associate relations/EEO policies.
Must Reside in the following area:
How we reward you:
- Hybrid remote schedule
- 401K with company match
- Yearly bonus opportunity*
- Full medical, dental, and vision insurance *
- On-site fitness center, biometric screen, and flu shot clinic
- Discounts at Panda restaurants, theme parks, and gym memberships
- Paid time off starting at 15 days with 7 federal holidays*
- Continuous education assistance and scholarships*
- Income protection including Disability, Life and AD&D insurance*
- Bereavement leave*
*Benefits available for eligible permanent full time associates Your background & experience:
- College degree or comparable experience required
- Minimum five years of experience in workers' compensation investigations, insurance fraud, risk management, or a related field
- Valid Class C Driver's License required
- Certified Professional in Fraud Identification (CPFI) or Private Investigator license preferred
- Successful completion of initial and periodically required training (including but not limited to store training, Recognizing & Preventing Sexual Harassment training, Conscious inclusion training, and Landmark Forum, etc.)
- Obtaining a valid Food Handler's Card within 30 days of employment is a requirement of this position.
Pay Range: P3: $90,000-$126,000 * Within the range, individual pay is determined using various factors, including work location and experience. #LI-Remote
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Panda Restaurant Group Inc
vision insurance, paid time off, 401(k)
Jul 25, 2025