SIU Investigator - Hybrid - Rancho Cordova, CA
About The Position
Travelers Investigative Services is seeking an SIU Investigator to investigate claims deemed suspicious across all lines of business in support of a Claim Center. The investigator analyzes, summarizes, and prioritizes information to uncover potentially fraudulent activity, conducting thorough investigations in a dynamic, fast-paced environment. The ideal candidate must reside in or near Sacramento. The role involves insurance investigations, database searches, specialized investigative work, analysis of technical information, coordination with internal and external partners, and application of evidence rules and applicable statutes. The investigator also identifies cases for potential prosecution and submits questionable claims to the National Insurance Crime Bureau. The position requires adapting to new technologies and digital tools, including AI, while maintaining productivity and service quality.
Requirements
- At least two years of investigative experience, or at least three years of insurance claims, underwriting, or legal-related experience.
- Analytical and problem-solving skills to interpret information and facts and apply critical techniques to investigations.
- Strong case management skills and ability to manage work independently.
- Ability to work in a high-volume, fast-paced environment while managing shifting priorities.
- Influence and conflict management skills.
- Working-level knowledge of insurance and claim operations, Commercial Lines, Personal Lines, and Workers Compensation insurance products.
- Must reside in or near Sacramento.
Nice To Haves
- Bachelor's Degree.
Responsibilities
- Conduct insurance investigations and database searches to uncover potentially fraudulent aspects of claims.
- Periodically engage in specialized investigative areas, including Medical, Cyber, Cargo, and Fire Motive & Opportunity.
- Analyze, monitor, and summarize technical information into actionable investigative strategies; apply critical thinking to complex problems.
- Maintain contact with business partners, customers, and external resources throughout investigations, including claim, legal, and underwriting partners, public officials, and law enforcement officers.
- Serve as a fraud subject matter expert and liaison to business and industry partners.
- Apply rules of evidence, recognize and assess evidence, and collect and interpret evidence relevant to claims.
- Apply local, state, and federal statutes to ensure investigations comply with applicable law and local office expectations.
- Identify cases for potential insurance fraud prosecution and submit questionable claims to the National Insurance Crime Bureau.
- Adapt to new technology implementations, system upgrades, and digital tool rollouts, particularly those involving AI, while maintaining productivity and service quality.
- Perform other duties as assigned.
Benefits
- Employees are eligible for performance-based cash incentive awards.
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What This Job Offers
Job Type
Full-time
