Insurance fraud investigator • scottsdale az
The SIU Investigator role supports the organization's anti-fraud objectives by conducting timely investigations into claims where indicators of potential fraud, misrepresentation, or suspicious act... Show more
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The average salary range is between $ 44,159 and $ 84,900 year , with the average salary hovering around $ 49,571 year .
The SIU Investigator role supports the organization's anti-fraud objectives by conducting timely investigations into claims where indicators of potential fraud, misrepresentation, or suspicious activity exist and contributing to proper claim outcomes.
The SIU Investigator is responsible for conducting timely investigations into claims where indicators of potential fraud, misrepresentation, or suspicious activity exist. This role supports the organization's anti-fraud objectives by gathering facts, evaluating information, and contributing to proper claim outcomes while handling assignments of moderate complexity and collaborating with senior SIU personnel on higher-complexity matters as needed.
Evaluate referred claims to determine whether suspicious circumstances are present
Conduct interviews, review documentation, and research internal and external data sources to develop a factual understanding of each case
Maintain accurate and timely documentation of investigative findings
Coordinate with claims personnel throughout the investigative process
Complete regulatory compliance fraud referrals to state and federal agencies, as well as NICB, in accordance with applicable requirements
Support investigative strategy development and coordinate with vendors when appropriate
Contribute to departmental anti-fraud initiatives and ongoing improvement efforts
Maintain consistent, professional communication with internal and external partners
Manage multiple assignments while adhering to established guidelines, expectations, and timelines
Qualifications:
Minimum of 3 years of prior SIU experience with demonstrated proficiency in investigating multiline claims
Experience in workers' compensation and/or auto claims
Education Requirement:
Bachelor's Degree is preferred
Professional designations such as CIFI, FCLS, FCLA, or CFE are beneficial but not required
Additional Requirements:
Location and Travel: Primary location Urbandale, IA. Additional locations: Irving, TX; Chesterfield, MO; Glen Allen, VA; Florida; Atlanta, GA; West Hartford, CT; Scottsdale, AZ; High Point, NC. Travel: Occasional travel may be needed.
Sponsorship Details:
Sponsorship not Offered for this Role
