SIU Investigator - P&C

About This Role

Protect USAA and its members from potential fraudulent claims by investigating questionable activity and ensuring compliance with state insurance fraud laws. This role is remote in Washington or Oregon and involves applying knowledge of P&C insurance and investigative techniques.

Responsibilities

• Apply knowledge of fraud schemes and investigation strategies on questionable or suspect claims
• Participate in the development of fraud prevention strategies
• Apply knowledge of P&C insurance industry products, services, and processes in investigating claims
• Apply knowledge of state laws and regulations pertaining to insurance fraud in investigating claims
• Collect evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools
• Make recommendations within defined authority guidelines
• Prepare and present detailed and comprehensive verbal and written investigative reports
• Develop and maintain external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention
• Assist with the delivery of fraud awareness training initiatives
• Handle CAT duty responsibilities as business requires
• Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled

Requirements

• High School Diploma or General Equivalency Diploma (GED)
• 2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience
• Proven investigatory skills
• Experience obtaining statements from various parties to incidents, witnesses, and suspects
• Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud
• Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems
• Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems
• Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology

Qualifications

• High School Diploma or General Equivalency Diploma (GED)
• 2+ years claims adjusting or SIU/Fraud investigation experience OR 4+ years investigative law enforcement/relevant fraud industry investigation experience

Nice to Have

• SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience
• Strong Property SIU experience
• Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other
• US military experience through military service or a military spouse/domestic partner

Benefits