SIU Investigator

Responsibilities

• Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers’ compensation, general liability, property and casualty and disability.
• Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of 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, training tasks, consulting projects, and other assignments as directed.
• 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.

Qualifications

• Must possess one or more of the following:
• Bachelor’s degree in Criminal Justice
• 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
• Ability to be properly licensed as a Private Investigator as required by the state where work Is completed
• Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
• Minimum of five (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
• Flexibility to work varied and irregular hours and days including weekends and holidays

Preferred Qualifications

• Military experience
• Law enforcement
• Insurance administration experience
• Familiarity with California SIU regulations
• One or more of the following professional industry certifications:
• 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)