SIU Field Investigator II

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Position Summary :

The SIU department encompasses low to moderately complex claims investigations of suspicious and fraudulent claims investigation. The unit reports information to and coordinates with law enforcement or state fraud bureaus for regulatory compliance and criminal prosecutions.

Description : Position Summary :

The SIU department encompasses low to moderately complex claims investigations of suspicious and fraudulent claims investigation. The unit reports information to and coordinates with law enforcement or state fraud bureaus for regulatory compliance and criminal prosecutions.

The position is responsible for conducting in-depth field investigations of suspicious property insurance claims that vary in complexity. These investigations may be of suspicious or unlawful activity by policyholders, vendors and others and are conducted in a prompt, expeditious and ethical manner.

Essential Functions :

• Prioritize assignments and conduct necessary field work exercising independent judgment, initiative and decision-making skills.
• Analyze facts and data, telephonic interviews, and a review of claim documents.
• Drafting thorough detailed investigative reports to include developing the appropriate investigative action that justifies a proper recommendation to claims adjusters and management.
• SIU supports its independent IA firms and internal departments, when needed, that may include identifying training needs; participation in developing and presenting training to raise the awareness of potential fraud.
• Regularly meet with claims management to keep them informed of trends that may have an impact on claims in a specific assigned region / territory.
• Develop and maintain industry, federal, state, and local government contacts involved in fraud investigation, detection, and prevention.
• Maintain and pursue technical competency by continuous learning in fraud education with an emphasis on insurance fraud seminars and other company sponsored courses at the direction of the SIU Manager. Attend monthly meeting facilitated by regulatory agencies and other fraud related organizations
• Conduct Field investigations to include neighborhood canvasses, interviewing vendors, scene photos, business inquiries, asset recovery, etc.
• Aid our legal team in preparation for litigation or subrogation, skip trace for witnesses, etc.
• Travel 50% -70%

Qualifications : Required Education and Experience :

Preferred Qualifications :

Seniority level

Employment type

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Industries

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