SIU Investigator

UNIVISTA HOLDINGS LLC•Miami Springs, FL

8d•$45,000 - $65,000•Hybrid

About The Position

Loyalty MGA is seeking an SIU Investigator to identify and investigate potentially fraudulent claims. The role involves conducting thorough investigations, gathering evidence, and collaborating with internal teams to prevent and detect fraud. The position offers a hybrid work schedule after successfully completing the company’s probation period. The investigator also negotiates settlements with claimants or their representatives, aiming for fair and equitable agreements, and handles claims in accordance with ethical standards. The role calls for someone who is detail-oriented, communicates effectively, and can work in a fast-paced environment while adapting to changing priorities.

Requirements

High school diploma or GED.
At least 6 months of claims handling or investigative experience in any field.
Bilingual in English and Spanish.
Strong customer service and communication skills.
Basic proficiency in Microsoft Office.
Strong problem-solving skills, with a focus on timely and effective resolutions to customer issues.
Strong organizational and time management skills to handle multiple tasks efficiently.
Professional and energetic approach, with the ability to thrive in a fast-paced environment and adapt to changing priorities.
Excellent verbal and written communication skills, including the ability to articulate solutions clearly and concisely.

Nice To Haves

Experience in loss prevention and surveillance.
Active insurance adjuster’s license; must obtain and maintain one as needed.
Bachelor’s degree in business or a related field.

Responsibilities

Investigate suspicious claims for potential fraud, including conducting interviews and surveillance and collecting evidence.
Analyze claims data to identify patterns and red flags that may indicate fraudulent activity.
Prepare detailed investigation reports documenting findings and supporting evidence.
Present investigative findings to management and regulatory bodies as needed.
Work with claims adjusters, legal teams, and law enforcement to support fraud investigations.
Assist in developing strategies to prevent fraud and improve claims processes.
Ensure investigations comply with company policies, industry regulations, and legal requirements.
Maintain confidentiality of sensitive investigative information.
Negotiate settlements with claimants or their representatives, ensuring fair and equitable agreements.
Adhere to ethical standards and guidelines when handling claims and interacting with stakeholders.