SIU Investigator

About This Role

This role involves independently investigating suspected fraudulent insurance claims, ranging from workers' compensation to property and casualty. The SIU Investigator will gather information, maintain detailed documentation, and produce professional reports to determine if claims warrant reporting for prosecution.

Responsibilities

• Independently investigate suspected fraudulent insurance claims for various coverages including workers' compensation, general liability, property and casualty, and disability
• Acquire and gather information through data collection, interviews, research, and collaboration with SIU entities, law enforcement, and state Departments of Insurance
• Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments
• 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 where work is completed
• Bachelor's degree in Criminal Justice or High School diploma/equivalent with 5+ years professional law enforcement experience related to fraud investigations
• 5+ years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims
• Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area
• 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 or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud
• 5+ years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud, or 5+ years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims.

Nice to Have

• Military experience
• Law enforcement experience
• Insurance administration experience
• Familiarity with California SIU regulations
• Certified Fraud Examiner (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