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Field Investigator II

Key Facts

Remote From: 
Full time
Mid-level (2-5 years)
English

Other Skills

  • •
    Investigation
  • •
    Analytical Skills
  • •
    Report Writing
  • •
    Decision Making
  • •
    Training And Development

Roles & Responsibilities

  • Strong analytical and decision-making skills
  • Excellent communication and interpersonal skills
  • Ability to conduct thorough investigations
  • Knowledge of fraud detection and prevention techniques

Requirements:

  • Conduct in-depth field investigations of suspicious property insurance claims
  • Draft detailed investigative reports and make recommendations
  • Meet regularly with claims management to discuss trends and impact on claims
  • Develop and maintain contacts in fraud investigation and prevention

Job description

Position Summary: 

The SIU department encompasses complex claims investigations of suspicious and fraudulent claims investigation.  The unit reports information to and coordinates with law enforcement and state fraud bureaus for regulatory compliance and criminal prosecutions.

The position is responsible for conducting in-depth field investigations of suspicious property insurance claims that vary in complexity.  These investigations may be suspicious or unlawful activity by policyholders, vendors and others and are conducted in a prompt, expeditious and ethical manner. 

Essential Functions:

  • Prioritize assignments and conduct necessary field work exercising independent judgment, initiative and decision-making skills.
  • Analyze facts and data, telephonic interviews, and a review of claim documents.
  • Drafting thorough detailed investigative reports to include developing the appropriate investigative action that justifies a proper recommendation to claims adjusters and management.
  • SIU supports its independent IA firms and internal departments, when needed, that may include identifying training needs; participation in developing and presenting training to raise the awareness of potential fraud.  
  • Regularly meet with claims management to keep them informed of trends that may have an impact on claims in a specific assigned region/territory. 
  • Develop and maintain industry, federal, state, and local government contacts involved in fraud investigation, detection, and prevention.
  • Maintain and pursue technical competency by continuous learning in fraud education with an emphasis on insurance fraud seminars and other company sponsored courses at the direction of the SIU Manager.  Attending monthly meetings facilitated by regulatory agencies and other fraud related organizations
  • Conduct Field investigations to include neighborhood canvasses, interviewing vendors, scene photos, business inquiries, asset recovery, taking statements in person, etc.  
  • Aid our legal team in preparation for litigation or subrogation, skip trace for witnesses, etc.
  • Travel 50% -70%

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