SIU Investigator
Job Details
Description
SIU Investigator
Job Summary: The Special Investigation Unit (SIU) Investigator position is responsible for performing and/or coordinating activities in the investigation of incidents
involving suspected fraud. The position is also responsible for insuring that the Company complies with all SIU regulations promulgated by the various insurance departments.
Major Accountabilities
• Conduct in-depth investigations related to potentially fraudulent claims while
validating meritorious claims.
• Understand all facets of claims processes to a working level and be able to
manage multiple priorities and peak workloads.
• Supervise and monitor activities of outside Special Investigation vendors during
the investigation of the claim.
• Work with UW, Accounting, and all business units to identify potential fraud,
uncover opportunities to prevent leakage and mitigate loss.
• As needed perform background and asset checks on individuals and businesses.
• With SIU team conduct company-wide SIU training.
• Perform other duties as assigned by Management.
Qualifications
Education/Training Requirements: Bachelor or commensurate
Experience Required.
Experience/Specialized Skills: Minimum three investigating potentially fraudulent activity and/or fire and theft claims required. Advanced
knowledge of SIU compliance laws and regulations required. Familiarity with basic insurance law, understanding of basic legal principles and terminology as it
relates to insurance operations and knowledge of medical terminology and procedures required. Intermediate computer skills (word processing, spreadsheets,
databases, Internet, e-mail) required.
Special Considerations
Physical Requirements: Constant use of vision, hearing, and communication (oral and written in person and via telephone). Frequent concentration, standing, walking, handling, reaching, and grasping. Occasional bending, kneeling and lifting (up to 25 lbs.) Heavy use of computer and office equipment.
Travel/Hours of Service: Occasional travel required. Around-the-clock
accessibility during on-going investigations is required. Periodic work outside of
standard business hours or on weekends required.
Insurance
Other, Information Technology, and Management
Full-time