SIU Claims Coordinator

Coaction Specialty Insurance Group•Morristown, NJ

22d•$60,000 - $90,000•Hybrid

About The Position

At Coaction, we’re a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients. Position Summary: The SIU Claims Specialist is responsible for leading the company’s Special Investigations Unit, working with the Coaction approved investigation panel, overseeing the detection, investigation, and prevention of fraudulent insurance claims across all lines of business. This role ensures compliance with state and regulatory reporting requirements, drives investigative best practices, and partners closely with claims leadership, underwriting, and legal teams to mitigate fraud risk and protect company assets.

Requirements

Bachelor’s degree in criminal justice, Business, Risk Management, or related field preferred.
3+ years of insurance claims or investigative experience
Prior Law Enforcement, SIU or Insurance Fraud experience strongly preferred.
This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.

Nice To Haves

Professional certifications such as CIFI, CFI, CFE, FCLS, or PCI is highly desirable.

Responsibilities

Manage workflow, case assignments, and performance metrics to ensure timely and effective investigations.
Establish and maintain investigative standards, protocols, and quality controls.
Oversee the identification of suspicious claims through analytics, adjuster referrals, and external intelligence.
Direct and support complex or high-exposure investigations.
Where appropriate coordinate field investigations, interviews, scene inspections, surveillance, background and social media investigations and evidence collection.
Ensure proper documentation and investigative reporting to support claim decisions and potential litigation.
Maintain full compliance with all state SIU regulations, reporting requirements, and fraud registry submissions.
Serve as the primary contact for state fraud departments, law enforcement, and regulatory agencies.
Assist in preparing and submitting mandated annual SIU plans, training documentation, and statistical reports.
Partner with Claims leadership to identify fraud trends and provide recommendations for process improvements.
Work with Underwriting to communicate emerging fraud patterns, risk indicators, and underwriting controls.
Support the Legal department in cases progressing to litigation or criminal prosecution.
Coordinate and/or deliver fraud awareness training to adjusters, examiners, and other business units.
Utilize data analytics tools to identify fraudulent patterns, emerging schemes, and abuse trends.
Develop dashboards, reports, and KPIs to measure unit effectiveness and program impact.
Present fraud insights and trends to executive leadership.
Manage relationships with external investigative vendors, surveillance firms, forensic experts, and law enforcement.
Evaluate vendor performance and ensure cost-effective use of external resources.