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[Remote] SIU Investigator (mid-level) - P&C Multi-line (WI, MI, IL, or OH)
Note: The job is a remote job and is open to candidates in USA. USAA is dedicated to empowering its members to achieve financial security through competitive products and exceptional service. They are seeking a mid-level SIU Investigator to protect members from fraudulent claims by investigating questionable claims activity in compliance with insurance laws and regulations.
Responsibilities
- Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims
- Participates in the development of fraud prevention strategies
- Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures
- Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims
- Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools
- Makes recommendations within defined authority guidelines
- Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome
- Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention
- May serve as a resource team member on specific matters through demonstrated skill or training
- Assists with the delivery of fraud awareness training initiatives in a defined environment
- Handles CAT duty responsibilities as business requires
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures
Skills
- High School Diploma or General Equivalency Diploma (GED)
- 2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience
- Proven investigatory skills
- Experience obtaining statements from various parties to incidents, witnesses, and suspects
- Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud
- Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems
- Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems
- Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology
- SIU experience conducting low to complex P&C fraud investigations
- Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other
- US military experience through military service or a military spouse/domestic partner
Benefits
- Comprehensive medical, dental and vision plans
- 401(k)
- Pension
- Life insurance
- Parental benefits
- Adoption assistance
- Paid time off program with paid holidays plus 16 paid volunteer hours
- Various wellness programs
- Career path planning and continuing education
Company Overview
