SIU Senior Investigator

EMC Insurance Companies

20h•Remote

About The Position

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. This position is eligible to work from home anywhere in the United States

Requirements

Bachelor’s degree in business, insurance, criminal justice or related field or equivalent relevant experience
Five years of claims adjusting, investigation or insurance experience or related experience
Strong knowledge of the investigative process, including proper identification and collection of physical evidence
Strong knowledge of civil and criminal investigative procedures and the legal system
Strong knowledge of various statement taking techniques, collection and analysis of public and private records
Good knowledge of property and casualty insurance industry and fraud awareness preferred
Strong investigative skills and ability to make sound decisions
Good conflict resolution, negotiation and facilitation abilities
Ability to work independently and as part of a team
Strong verbal and written communication skills, including file documentation and report writing
Good knowledge of computers and Microsoft Office Suite
Attendance of the National Insurance Crime Bureau SIU Academy within the first two years of hire
Occasional travel; a valid driver’s license with an acceptable motor vehicle report per company standards required if driving

Nice To Haves

Prior property and casualty experience preferred
Fraud Claim Law Specialist (FCLS) designation within the first year of hire
Insurance designations, such as INS or AIC, preferred

Responsibilities

Promptly investigates and evaluates SIU referrals of moderate to high complexity, including organized ring activity
Reviews claim, underwriting and premium audit files pertinent to the referral
Initiates contact with other departments, insureds, claimants, witnesses, vendors, other carriers, attorneys, law enforcement or any others to obtain information
Researches background information, including public records, claims history and social media sites
Takes statements from insureds, claimants, witnesses and other pertinent parties.
Documents all special investigative handling and activity
Reviews the facts of an investigation and completes field investigations
Attends examinations under oath (EUOs) and depositions for assigned cases
Secures and reviews bills, invoices, receipts and other documentation for legitimacy and accuracy
Tracks trends and patterns of investigations regarding organized ring activity
Provides status updates on special investigations to branch or corporate office team members, agents, defense counsel and law enforcement entities
Identifies, investigates and pursues opportunities for recovery or restitution
Develops and evaluates investigative data and evidence to formulate recommendations
Conducts analysis of all investigative materials to formulate a recommendation for further handling, including payment, compromise or denial of a claim or rescission of a policy
Prepares a special report with written summaries of all investigative data
Communicates with branch and corporate office departments, as well as other impacted entities, regarding investigative activities and evidence to support or exonerate potential fraud
Prepares documentation in compliance with a state’s anti-fraud reporting requirements on each investigation
Prepares evidence packets related to civil litigation or criminal prosecution for submission to defense counsel, National Insurance Crime Bureau (NICB), State Fraud Bureaus and/or Attorney General’s offices or other law enforcement entities
Develops assigned internal and external anti-fraud training and marketing of SIU services
Develops assigned internal and external anti-fraud training
Provides anti-fraud training to internal and external customers through investigative discussions and dissemination of educational materials
Collaborates with team members in developing marketing strategies for the SIU department and its services
Implements assigned marketing strategies
Participates in the establishment of effective policy standards, practices, techniques and procedures for the investigation, evaluation and disposition of the SIU referral.
Maintains active involvement in professional associations within the industry.

Benefits

More than 105 years of financial strength and stability
Named a five-star insurance carrier by Insurance Business America
Two-time recipient of the Best Practices Award of Excellence from the Independent Agents & Brokers of America
Multiple locations recognized as Top Workplaces based solely on team member feedback
Corporate culture that engages and empowers team members to achieve their best
Outstanding benefits with life, medical, dental, vision and prescription drug coverage
Competitive paid time off plan and a full day of volunteer time off annually
Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
Professional development and growth opportunities, including tuition reimbursement
Wellness initiatives to improve team member well-being and reduce health insurance costs
Flexibility to dress for your day and opportunities for alternative work arrangements