SIU Investigator II Desk

Under limited supervision, conducts extensive and detailed investigations of suspicious losses or organized schemes involving staged accident rings, providers, etc. to determine compensability of submitted claims.

Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.

This a range posting Grade 12 – 13, Level of position offered will be based on skills and experience at manager discretion.

For candidates who reside within 50 miles of the office, a minimum of 2 days per month will be required. For candidates outside of 50 miles, we will offer remote.

Responsibilities:

• Independently develops and executes appropriate investigation strategy for assigned cases. Leads in-depth interviews of participants, witnesses or claimants.
• Completes detailed and extensive investigations in adherence with SIU procedures and best practices. Gathers evidence and makes determinations regarding compensability. Engages experts and vendors as warranted.
• Communicates investigation outcome to line of business claims personnel. When non-compensable, fully executes the claim decision process and completes associated tasks.
• Establishes extensive network with law enforcement agencies and works in collaboration in the investigation of suspicious losses.
• Proactively partners with line of business claims personnel to generate referrals. Partners with various SIU and line of business claims personnel to determine merits of initiating organized scheme investigations.
• May evaluate incoming referrals to determine appropriate SIU investigation assignments.
• Provides fraud awareness training to internal stakeholders. Serves as a resource to claims personnel.
• May represent the Company and actively participate in industry association meetings by providing training to industry SIU personnel or law enforcement. Shares intelligence and trends with PI SIU and other internal stakeholders.