SIU Claims Investigator

AIG • Atlanta, GA

7d • Onsite

About The Position

The SIU Claims Investigator is responsible for all aspects of the investigation process to include creation of investigation plans, identification and assignment of relevant enquiries and reporting on findings. The investigator will provide assistance to the claims adjuster in progressing the claim and will leverage knowledge and expertise to ensure that the fraud risk to AIG is minimized. As an Insurance Claims Investigator, you will be responsible for investigating high complexity suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, brokers, lawyers, medical providers, etc., to support the Claims organization.

Requirements

• College degree preferred or equivalent work experience.
• Advanced knowledge of criminal and civil justice systems and relevant data and compliance legislations
• Excellent oral and written communication skills and thorough working knowledge of MS Office applications.
• An understanding of local customs, insurance markets and languages is desired.
• Ability to manage workflow to identify and pursue leads that would support a fraud case.
• Ability to work to tight timelines when necessary
• Advanced working knowledge in investigating General Insurance Consumer & Personal Lines of insurance a plus
• Ability to analyze complex data sets to assess trends and identify opportunities to drive improvements
• PC skills and experience with various database search systems, internet, and social networking for investigative purposes.

Responsibilities

• Obtain and preserve physical and documentary evidence to support investigations.
• Coordinate necessary investigative techniques and resources, such as fieldwork through internal or external field resources, interviews, etc. and ensuring quality is accurate, timely and appropriate on all cases.
• Handle a full caseload of primarily high complexity investigations including organized ring activity, provider fraud, premium avoidance, and other major case investigations across relevant jurisdictions while ensuring all tasks are completed properly.
• Testify and present evidence at administrative and criminal court proceedings as required.
• Establish and maintain professional working relationships with insureds, lawyers, corporate employees, vendors, police and relevant fraud bodies.
• Complete targeted claims reviews for all lines of business within AIG as assigned. This includes analysis, documentation of results and suggestions for improvement.
• Accurately identify and record all financial impact for cases worked in the case management system.
• Assist GIS and local management as appropriate in ensuring key deliverables and business objectives are met.
• Awareness of, and adherence to, local laws regarding techniques used for information gathering in countries where operating.
• Provide intelligence feedback to claims and underwriting departments regarding loss trends and opportunities for future fraud mitigation.
• Manage all aspects of the claims investigation, to include analyzing facts on issues in question, thorough review of interviews and statements of witnesses, employers, claimants and other relevant witnesses.
• Gather facts on issues in questions through open-ended interviewing and statement taking of witnesses, employers, claimants, and other relevant witnesses.
• Prepare objective and concise written reports of investigations when necessary.
• Identify, create, and complete fraud training for various lines of business supported by AIG.
• Complete focused claims reviews for all lines of business within AIG domestically as assigned. This includes analysis, documentation of results and suggestions for improvement.
• Assist team on ad-hoc duties, projects, and other assignments delegated by Managers/Leaders.

Benefits

• Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree