SIU Desk Investigator - Tampa
About The Position
AssuranceAmerica is hiring an SIU Desk Investigator to support its Special Investigations Unit and claims departments by investigating suspected insurance fraud involving applications, auto and property claims, and injury claims. The role conducts low- to moderate-complexity investigations and analyzes suspicious claims using investigative methods and techniques. Investigators plan, prioritize, and carry out assignments that may include background research, interviews, and Examinations Under Oath, then evaluate relevant information and report findings. The role requires an understanding of legal and claims principles, insurance coverage, and personal injury protection coverage. This is an in-office position. Candidates must currently live in the greater Tampa area; relocation assistance is not available. The position requires a bachelor's degree in criminal justice, finance, business administration, or a related field, two years of prior SIU investigator or claims-handling experience, and a Florida Insurance Adjusters License within 90 days of employment. Previous experience in insurance claims investigation, fraud detection, or law enforcement is helpful.
Requirements
- Bachelor's degree in criminal justice, finance, business administration, or a related field.
- Two years of prior SIU investigator or claims-handling experience.
- Working understanding of coverage and the requirements of personal auto policies and/or personal injury protection coverage.
- Florida Insurance Adjusters License required within 90 days of employment.
- Excellent communication and interpersonal skills, including the ability to interact effectively with diverse stakeholders.
- Attention to detail and ability to maintain confidentiality when handling sensitive information.
- Proficiency in relevant software applications for data analysis and documentation.
- Knowledge of insurance laws, regulations, and industry standards related to fraud investigation.
- Ability to manage multiple cases and prioritize tasks.
- Strong analytical, problem-solving, interviewing, organizational, and time-management skills.
- Strong verbal and written communication skills.
- Ability to provide customer-oriented service and interact effectively with clients, colleagues, and stakeholders.
- Integrity and adherence to confidentiality standards, industry regulations, and professional codes of conduct.
- Adaptability and willingness to learn new concepts and technologies.
- Ability to collaborate effectively with colleagues and professionals across insurance functions.
Nice To Haves
- Previous experience in insurance claims investigation, fraud detection, or law enforcement.
- Knowledge of medical terminology, medical billing, and CMS 1500 forms.
Responsibilities
- Conduct Examinations Under Oath and report findings.
- Investigate claims, including taking statements and analyzing and verifying documents and damages.
- Provide office training to help associates recognize potentially suspicious or fraudulent files.
- Ensure compliance with industry and company policies.
- Understand regulatory and statutory requirements and maintain knowledge of changes in state and national law.
- Use claims and other relevant systems appropriately.
- Attend industry meetings to identify industry trends.
- Complete an individual weekly investigator report for the manager.
- Attend and participate in team meetings and roundtables.
- Maintain a network of SIU, claims, law enforcement, attorney, and related contacts to keep investigative methods and procedures current.
- Meet individual goals and objectives.
- Interact consistently, fairly, and diplomatically with coworkers.
- Perform other duties assigned by the SIU Manager.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
