SIU Desk Investigator

AssuranceAmerica•Tampa, FL

16d

About The Position

A Special Investigations Unit (SIU) Desk Investigator within an insurance company plays a crucial role in assisting the SIU and claims departments with fraudulent activities related to insurance claims. The Desk Investigator conducts low to moderate investigations involving suspicions of insurance fraud related to the application of insurance, auto/property, and injury claims. The Desk Investigator plans, prioritizes, and executes investigative assignments, including backgrounds, interviews, and Examinations Under Oath. The Investigator is responsible for analytical review of suspicious claims utilizing various investigative methods and techniques. The investigator must evaluate relevant information essential in resolving suspicious and complex investigations. This position requires demonstrated effectiveness in the understanding and application of legal and claim principles. The Investigator should have a working understanding of coverage and or personal injury protection coverage. The primary role of the desk investigator will be to conduct Examinations Under Oath, and report the findings of same. Claims Investigations to include but not limited to: statements, document analysis/verification, damage analysis Provides office training to ensure recognition of potentially suspicious or fraudulent files in the branch Must ensure compliance with industry and company policies Must understand regulatory / statutory requirements; develops and maintains knowledge of changes in law both at state and national levels Properly utilizes our claims and other various systems Attends industry meetings to identify industry trends Completes individual weekly Investigator report to manager Attends and participates in team meetings, roundtables Actively affiliates and maintains network of SIU, claims, law enforcement, attorney, and related contacts to ensure investigation methods are current and proper operating procedures are utilized Responsible for meeting individual goals and objectives Maintains consistent, fair, and diplomatic interactions with co-workers Performs other duties as assigned by SIU Manager We strive for excellence in how we serve our policy holders and agents, and have since we opened our doors in 1998. We believe in creating a culture where all associates have a chance to learn and grow. We also take part in directing 5% of our earnings to fight homelessness, which gives hope with every policy purchased. We're grateful for the team we've created and the values we stand behind. We've pledged to be direct, results driven, and dedicated to the success of our business and each other.

Requirements

Demonstrated effectiveness in the understanding and application of legal and claim principles.
Working understanding of coverage and or personal injury protection coverage.

Responsibilities

Plans, prioritizes, and executes investigative assignments, including backgrounds, interviews, and Examinations Under Oath.
Responsible for analytical review of suspicious claims utilizing various investigative methods and techniques.
Evaluates relevant information essential in resolving suspicious and complex investigations.
Conduct Examinations Under Oath, and report the findings of same.
Claims Investigations to include but not limited to: statements, document analysis/verification, damage analysis
Provides office training to ensure recognition of potentially suspicious or fraudulent files in the branch
Ensures compliance with industry and company policies
Understands regulatory / statutory requirements; develops and maintains knowledge of changes in law both at state and national levels
Properly utilizes our claims and other various systems
Attends industry meetings to identify industry trends
Completes individual weekly Investigator report to manager
Attends and participates in team meetings, roundtables
Actively affiliates and maintains network of SIU, claims, law enforcement, attorney, and related contacts to ensure investigation methods are current and proper operating procedures are utilized
Responsible for meeting individual goals and objectives
Maintains consistent, fair, and diplomatic interactions with co-workers
Performs other duties as assigned by SIU Manager