SIU Investigator Senior (Major Case Unit)

USAA•Washington, DC

2d•$93,770 - $179,240•Remote

About The Position

USAA is seeking a dedicated SIU Investigator Senior - Major Case Unit to join their team. This role is responsible for protecting USAA and its members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact. The position involves working with Legal Counsel, government agencies, and outside consultants in compliance with state laws and regulations. This is a remote-eligible, field-based role that can be located anywhere in the Continental United States. Relocation assistance is not available.

Requirements

High School Diploma or General Equivalency Diploma.
4+ years of P&C SIU/Fraud investigation experience; OR 6+ years relevant fraud industry investigation experience.
Expert knowledge and understanding of fraud investigations as well as application of case law and state laws and regulations.
Must be a skilled investigator with experience taking sophisticated statements from multiple parties to an event.
Ability to capture broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
Demonstrated ability to coordinate and prioritize workload, performing multiple tasks and devising solutions to problems.
Experience 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.
Experience in concurrent handling of specialty/complex/litigated claims/cases as well as mediation/arbitration/trial preparation and participation.
Meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver’s license.

Nice To Haves

At least 5 years of SIU/investigative experience in P&C
3+ years of experience conducting multi-claim major case investigations in multiple jurisdictions
Experience with Major Case investigations in more than one line of business (for example, auto/property/casualty)
Experience handling Major Case Investigation from start to finish with advanced report writing to submit for affirmative litigation.
Comprehensive experience applying various causes of action for potential affirmative fraud litigation
Experience working on projects within SIU
Experience leading or mentoring other SIU investigators
Subject Matter Expertise (SME) in at least one personal line of business (auto/property/casualty)
Industry recognized major designations (for example, CPCU, CFI, CFE)
US military experience through military service or a military spouse/domestic partner

Responsibilities

Leads the execution of fraud prevention strategies and investigative operations.
Leads high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals (e.g., organized provider rings, staged accidents, large losses of significant exposure and broad scale PIP/Casualty Schemes) across multiple entities or functions.
Applies advanced knowledge of P&C insurance industry products, services, and processes in investigating claims, including P&C insurance policy contracts and coverages and claims handling process and procedures.
Applies advanced knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
Processes large quantities of unstructured detailed information with high levels of accuracy by collecting 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 appropriate and prompt decisions to identify potential complex fraud within defined guidelines.
Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results and outcome of the investigation.
Serves as subject matter authority for team members, including providing expert mentorship and training for fraud investigations.
Develops and maintains external relationships with industry, law enforcement, and other contacts involved in fraud investigation, detection, and prevention.
Develops proactive actions and conveys compelling arguments to influence disposition of arbitrated and litigated cases effectively and efficiently.
Handles CAT duty responsibilities as business requires.
Ensures risks associated with business activities are effectively identified, measured, supervised, and controlled in accordance with risk and compliance policies and procedures.