SIU Investigator

Job Description:

• Conduct timely investigations, including recorded statements and interviews of claimants, witnesses, and employers
• Provide timely status updates to the case manager and client
• Document claim files clearly, accurately, and promptly
• Maintain confidentiality and professionalism
• Develop appropriate investigative action plans
• Ensure accuracy, quality, and timeliness of evidence and compliance with applicable laws, legal codes, and governing agencies
• Provide claim adjusters with investigation results and document findings
• Determine whether additional evidence is required, including accident reports, scene reconstructions, witness statements, police reports, and expert opinions
• Provide recommendations and decisions regarding investigative efforts
• Perform detailed database queries and analyze and organize critical SIU investigation data
• Evaluate state compliance referrals when questionable or suspicious activity is identified
• Maintain active membership in professional organizations providing SIU assistance and resources
• Establish and maintain relationships with law enforcement, government regulatory agencies, and insurance industry personnel

Requirements:

• Extensive experience with claims across insurance lines, especially Workers’ Compensation claims
• Strong investigative skills
• Detail-oriented
• Ability to recognize patterns of inconsistencies linked to fraudulent activity
• Ability to interact with clients, repair shops, appraisers, and employers
• Ability to work independently
• Excellent verbal and written communication skills
• Good organization and time-management skills
• Knowledge of tools and techniques for insurance claims investigations
• Proficiency with Word, Excel, Outlook, and Teams
• Laptop computer, cell phone, audio recording device with download capability, digital camera, and tape measure
• CFE or FCLS designations preferred
• 5–10 years of claims and SIU investigation experience preferred

Benefits: