SIU Investigator

Chubb•Town of Colonie, NY

2d•$57,000 - $83,000

About The Position

The SIU Investigator will be a key member of the SIU investigative team. This individual will work with Chubb Benefits’ Claims Department and existing SIU staff to identify and combat instances of insurance fraud. The Investigator will work collaboratively with the Claims Department and Legal to quickly identify and combat potential fraud in a business environment that values speed and service, allowing us to quickly process and pay legitimate claims for our policyholders. This individual will report to the leader of the SIU Department.

Requirements

An Associate’s or Bachelor’s degree in Criminal Justice or a related field, or five years of insurance claims investigation experience or five years of professional investigation experience with law enforcement agencies, or seven years of professional investigative experience involving economic or insurance fraud related matters.
Demonstrated understanding of the accident and health, and life insurance regulatory environment including HIPAA, GLBA, and other applicable privacy and data security regulations.
Strong analytical and technical skills in using data analytics and a deep understanding of insurance claims and fraud issues.
Demonstrated ability to develop relationships with business partners across the organization.
Ability to consistently execute and deliver results.
Ability to manage multiple cases in a dynamic business environment.
Strong knowledge of MS Project, Excel, PowerPoint Word; and other research tools.

Responsibilities

Manage SIU Investigations and provide frequent communication on ongoing investigations.
Manage investigative workflow and prioritize incoming and pending caseload.
Work collaboratively with Chubb Benefits’ Claims Department to develop individual investigative strategies to combat claim fraud in an efficient and effective manner for each case.
Develop and maintain relationships with, and provide timely guidance and advice to, business partners.
Document all case activity timely and in compliance with local regulations.
Assure all reporting to both internal management and state insurance departments is completed timely and in accordance with state and local regulations.
Assist in the preparation of responses to regulatory inquiries, complaints, and audits.
Conduct direct telephonic interviews with policyholders, and other parties associated with claims or policies.
Develop timely investigative plans to address identified suspicious activity relevant to potential intentional misrepresentation.
Report and escalate issues and developments as required.