SIU Investigator

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Job Description:

  • Conduct timely investigations, including recorded statements and interviews of claimants, witnesses, and employers
  • Provide timely status updates to the case manager and client
  • Document claim files clearly, accurately, and promptly
  • Maintain confidentiality and professionalism
  • Develop appropriate investigative action plans
  • Ensure accuracy, quality, and timeliness of evidence and compliance with applicable laws, legal codes, and governing agencies
  • Provide claim adjusters with investigation results and document findings
  • Determine whether additional evidence is required, including accident reports, scene reconstructions, witness statements, police reports, and expert opinions
  • Provide recommendations and decisions regarding investigative efforts
  • Perform detailed database queries and analyze and organize critical SIU investigation data
  • Evaluate state compliance referrals when questionable or suspicious activity is identified
  • Maintain active membership in professional organizations providing SIU assistance and resources
  • Establish and maintain relationships with law enforcement, government regulatory agencies, and insurance industry personnel

Requirements:

  • Extensive experience with claims across insurance lines, especially Workers’ Compensation claims
  • Strong investigative skills
  • Detail-oriented
  • Ability to recognize patterns of inconsistencies linked to fraudulent activity
  • Ability to interact with clients, repair shops, appraisers, and employers
  • Ability to work independently
  • Excellent verbal and written communication skills
  • Good organization and time-management skills
  • Knowledge of tools and techniques for insurance claims investigations
  • Proficiency with Word, Excel, Outlook, and Teams
  • Laptop computer, cell phone, audio recording device with download capability, digital camera, and tape measure
  • CFE or FCLS designations preferred
  • 5–10 years of claims and SIU investigation experience preferred

Benefits:

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