Special Investigator - Claims Special Investigation Unit (hybrid)

Utica National Insurance Group•New Hartford, NY

12d•Hybrid

About The Position

At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an “A” rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. This role may be performed hybrid to our office in New Hartford, NY; Buffalo, NY; or Charlotte, NC. What you will do Conducts investigations of assigned claims suspected of insurance fraud and other irregularities with a focus on thoroughness, quality, with attention to detail, timeliness and cost control. High degree of integrity and confidentiality required handling information that is considered personal and confidential. Ensures assigned cases are investigated and reported back to SIU Manager within prescribed time allowance. Customer service and relationship/team building by maintaining contact during the course of investigation with the company’s claim service, and underwriting departments. Encourages and participates in open communication with all Utica National in an effort to make claims operations more efficient and effective. Provides factual information gathered in investigations to Underwriting for purposes of evaluating risk. Maintains and fosters best possible relationship with the general public with special emphasis towards the following groups: policyholders, claimants, sales, and attorneys-at-law. Develops a network of resources within the community and maintains high degree of rapport and cooperation with federal, state, and local governmental agencies, as well as private information bureaus that can assist in investigative efforts. Testifies in civil and criminal courts. Maintains and pursues technical competency within area of specialization by attending insurance fraud seminars and other company-sponsored courses. Additional Responsibilities: May be responsible for guiding and training other investigators or claims staff with fraud training under the direction of the SIU Manager. May run special projects or initiatives with the planning and implementation responsibilities and accountability for outcome under the direction of the SIU Manager. Participates in professional organizations. Some contact with counsel may involve evenings or traveling to jurisdictions for depositions on behalf of the company. Assist in security issues involving company personnel and fraud matters. Assist Law Enforcement agencies involving requests for information and documentation on criminal matters. Some contact with counsel may involve evenings or traveling to jurisdictions for depositions on behalf of the company. Performs other duties as assigned. Conforms with all corporate policies and procedures.

Requirements

Bachelor’s degree in criminal justice or a related field, and/ or equivalent experience.
5-10 years of insurance claims investigation experience or professional investigation experience with law enforcement agencies.

Nice To Haves

SCLA designation preferred that includes completion of the Fraud Claims Law Associate courses.
Should obtain SCLA Silver and Gold designations.
Encouraged to pursue Auto Theft Investigator designations, Certified Fraud Examiner (CFE) designation and Certified Insurance Fraud Investigator (CIFI) designation and other acceptable insurance course work.

Responsibilities

Conducts investigations of assigned claims suspected of insurance fraud and other irregularities with a focus on thoroughness, quality, with attention to detail, timeliness and cost control.
Ensures assigned cases are investigated and reported back to SIU Manager within prescribed time allowance.
Customer service and relationship/team building by maintaining contact during the course of investigation with the company’s claim service, and underwriting departments.
Encourages and participates in open communication with all Utica National in an effort to make claims operations more efficient and effective.
Provides factual information gathered in investigations to Underwriting for purposes of evaluating risk.
Maintains and fosters best possible relationship with the general public with special emphasis towards the following groups: policyholders, claimants, sales, and attorneys-at-law.
Develops a network of resources within the community and maintains high degree of rapport and cooperation with federal, state, and local governmental agencies, as well as private information bureaus that can assist in investigative efforts.
Testifies in civil and criminal courts.
Maintains and pursues technical competency within area of specialization by attending insurance fraud seminars and other company-sponsored courses.
May be responsible for guiding and training other investigators or claims staff with fraud training under the direction of the SIU Manager.
May run special projects or initiatives with the planning and implementation responsibilities and accountability for outcome under the direction of the SIU Manager.
Participates in professional organizations.
Assist in security issues involving company personnel and fraud matters.
Assist Law Enforcement agencies involving requests for information and documentation on criminal matters.
Performs other duties as assigned.
Conforms with all corporate policies and procedures.

Benefits

Medical and Prescription Drug Benefit
Dental Benefit
Vision Benefit
Life Insurance and Disability Benefits
401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
Health Savings Account (HSA)
Flexible Spending Accounts
Tuition Assistance, Training, and Professional Designations
Company-Paid Family Leave
Adoption/Surrogacy Assistance Benefit
Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
Student Loan Refinancing Services
Care.com Membership with Back-up Care, Senior Solutions
Business Travel Accident Insurance
Matching Gifts program
Paid Volunteer Day
Employee Referral Award Program
Wellness programs