SIU Investigator

USAA•San Antonio, TX

3d•Hybrid

About The Position

As a dedicated SIU Investigator, within established guidelines and frameworks, you will investigate suspicious and questionable claims activity, ensuring compliance with all relevant state insurance fraud laws, regulations, policies, and procedures. This role requires a strong understanding of fraud schemes and investigation strategies to effectively analyze claims, gather evidence, and make informed recommendations. You will play a key part in safeguarding USAA's integrity and financial well-being by identifying and mitigating fraudulent activities.

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

SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations/Military Investigative 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.
Make 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.
Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and com