About The Position

USAA is seeking a mid-level SIU Investigator for a Field position in the San Diego metropolitan area. This role is responsible for protecting USAA and its members from fraudulent claims by investigating suspect claims activity in compliance with state laws and regulations. The ideal candidate will have a strong Property SIU background. This is a remote-eligible position, but requires the candidate to live in the San Diego metro area. A company car is provided, and regular business travel is expected.

Requirements

  • High School Diploma or General Equivalency Diploma (GED).
  • 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.
  • Proven 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.

Nice To Haves

  • SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience.
  • Strong Property SIU experience
  • Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other.
  • US military experience through military service or a military spouse/domestic partner

Responsibilities

  • Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims.
  • Participates 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.
  • Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
  • Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
  • Makes recommendations within defined authority guidelines.
  • Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
  • Develops 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 demonstrated skill or training.
  • Assists with the delivery of fraud awareness training initiatives in a defined environment.
  • Handles CAT duty responsibilities as business requires.
  • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

Benefits

  • Comprehensive medical, dental and vision plans
  • 401(k)
  • Pension
  • Life insurance
  • Parental benefits
  • Adoption assistance
  • Paid time off program with paid holidays
  • 16 paid volunteer hours
  • Various wellness programs
  • Career path planning
  • Continuing education
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