Job Description

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.

Job Tags

Weekend work,

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