SIU Investigator

About This Role

Investigate suspected fraudulent insurance claims across various coverages and determine if they warrant reporting to state agencies. This role involves data collection, interviews, research, and collaboration with law enforcement and Departments of Insurance.

Responsibilities

• Independently investigate suspected fraudulent insurance claims for workers' compensation, general liability, property and casualty, and disability
• Acquire and gather information through data collection, interviews, research, and collaboration with other SIU entities, law enforcement, and state Departments of Insurance
• Create and maintain detailed documentation for investigations, file reviews, audits, and training tasks
• Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct
• Run appropriate database indices if necessary and verify the accuracy of results found
• Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor

Requirements

• Valid driver's license with at least one year of driving experience
• Ability to be properly licensed as a Private Investigator as required by the state
• Ability to successfully complete the Allied Universal Investigations training/orientation course post offer
• Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards
• Proficient in utilizing laptop computers and cell phones
• Special Investigative Unit (SIU) Compliance knowledge
• Ability to type 40+ words per minute with minimum error
• Flexibility to work varied and irregular hours and days including weekends and holidays

Qualifications

• Bachelor's degree in Criminal Justice or High School diploma with professional law enforcement experience
• Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims. Or five (5) years of professional law enforcement experience with specific attention to investigations related to fraud.

Nice to Have

• Military experience
• Law enforcement experience
• Insurance administration experience
• Familiarity with California SIU regulations
• Certified Fraud Investigator (CFE)
• Certified Insurance Fraud Investigator (CIFI)
• Fraud Claim Law Associate (FCLA)
• Fraud Claim Law Specialist (FCLS)
• Certified Protection Professional (CPP)
• Associate in Claims (AIC)
• Chartered Property Casualty Underwriter (CPCU)

Benefits