SIU Investigator Intermediate - Field

USAA•Los Angeles, CA

2d•$77,120 - $147,390•Hybrid

About The Position

As a dedicated SIU Investigator, you will, within defined guidelines and framework, protect USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures.

Requirements

High School Diploma or General Equivalency Diploma.
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

US military experience through military service or a military spouse/domestic partner.

Responsibilities

Apply knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims.
Participate in the development of fraud prevention strategies.
Apply 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.
Apply 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.
Make recommendations within defined authority guidelines.
Prepare and present 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.
Assist with the delivery of fraud awareness training initiatives in a defined environment.
Handle CAT duty responsibilities as business requires.
Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.