[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