SIU "Field" Investigator - P&C (San Diego metro)

USAA•San Diego, CA

7d•$77,120 - $147,390•Hybrid

About The Position

USAA is seeking a mid-level SIU Investigator with a strong Property SIU background to join their team. This is a Field position based in the San Diego metropolitan area. The role involves investigating questionable or suspect claims activity to protect USAA and its members from potential fraud, in compliance with state laws and regulations. The selected candidate will apply knowledge of fraud schemes, investigation strategies, P&C insurance products, policy contracts, coverages, and claims handling processes. They will also collect evidence through interviews, database searches, and public records, make recommendations, and prepare detailed investigative reports. The role requires developing external relationships with industry, law enforcement, and other fraud-related contacts, and may involve assisting with fraud awareness training and handling CAT duty responsibilities. Ensuring risks are identified, measured, monitored, and controlled is also a key aspect of the position.

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.

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.