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SIU Investigator
| Company | USAA |
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| Location | Grand Rapids, MI, USA |
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| Salary | $77120 – $147390 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Mid Level, Senior |
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Requirements
- High School Diploma or General Equivalency Diploma.
- 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.
- Validated 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.
Responsibilities
- Apply knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims.
- Participate 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.
- Apply knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
- Collect evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
- Make recommendations within defined authority guidelines.
- Prepare and present detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
- Develop 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 proven skill or training.
- Assist with the delivery of fraud awareness training initiatives in a defined environment.
- Handle CAT duty responsibilities as business requires.
- Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
Preferred Qualifications
- 5 years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 5 years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience.
- Strong Property Claims / handling experience.
- Previous Insurance company experience.
- US military experience through military service or a military spouse/domestic partner.
