SIU Field Investigator

This is a fully remote position, open to applicants in United States.

📋 Description

• Investigate and assess complex, multi-disciplinary coverage and claims referred to the Special Investigations Unit (SIU) for potential fraud.

• Provide support for the Arkansas state territory across Auto, Homeowners, and Specialty Lines.

• Perform background checks, site investigations, clinic evaluations, recorded statements, witness interviews, and social media inquiries.

• Review and evaluate medical documentation, bills, property damage, and other claim-related materials.

• Ascertain whether fraud can be substantiated and assist in legal actions.

• Make determinations on claims regarding intricate investigations and pursue recovery of losses.

• Manage relationships with vendors and monitor their performance.

• Conduct online data searches, research, and assessments.

• Review investigations with fraud outcomes and confirm the appropriateness of denials.

• Carry out site inspections at body shops, medical facilities, loss locations, and similar venues.

• Address complex customer communications, concerns, conflicts, and issues.

• Utilize analytical tools and SIU field intelligence to pinpoint claims for investigation and substantiate evidence of fraud and damages.

• Summarize documents and enter notes into the claim system to record evaluations and decision-making processes.

• No supervisory responsibilities are included.

⛳️ Requirements

• Prior experience in investigations is mandatory.

• A strong preference for candidates with SIU experience.

• Proven experience in identifying, investigating, and resolving suspicious claims.

• Experience in conducting background checks, site investigations, clinic inspections, recorded statements, witness interviews, and social media inquiries.

• Proficient in reviewing and analyzing medical documentation, bills, and property damage.

• Capable of investigating intricate, multi-disciplinary coverage and claims, ECL claims, and significant losses.

• Possess analytical thinking, critical thinking, decision-making, fraud investigation, investigative interviewing, law enforcement, special investigations, surveillance, and time management skills.

• Must be authorized to work in the United States.

• Active insurance license holders are required to terminate existing appointments before onboarding and cannot hold external appointments during employment.

• Applicants with a resident producer license aiming for an adjuster position must relinquish that license when instructed.

• A dedicated, private home workspace that is free from distractions is essential.

• Reliable internet connection with minimum speeds of 50 MB download and 5 MB upload is required.

🏝️ Benefits

• Comprehensive technology setup, which includes a laptop, monitors, headset, keyboard, and mouse.

• Monthly reimbursement for connectivity for employees eligible to work from home.

• Opportunity for remote work arrangements.

• Commitment to equal employment opportunities and consideration for protected categories.

• Work visa sponsorship is not available.