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SIU Investigator

Employer
ICW Group
Location
San Diego, California
Salary
Not Specified
Closing date
Nov 23, 2019

View more

Category
Claims
Job Type
Not Specified
Career Level
Not Specified

Job Details

Our Special Investigations Unit (SIU) is seeking a motivated, results-oriented individual to join their team! As an SIU Investigator, your main purpose is to detect, prevent, and investigate suspected fraudulent claims to limit exposure and protect company assets. These investigations involve all lines of insurance with heavy emphasis on Workers’ Compensation Claims. An SIU Investigator maintains a systematic and effective method to detect and investigate suspected fraudulent claims and provide for their appropriate disposition.

Key responsibilities of the position include:

  • Educating and training all claim handlers, underwriters and integral insurance personnel to identify possible insurance fraud.
  • Ensuring investigative results are acted upon and measure ROI.
  • Evaluating all referrals for fraud and ensure essential data is located and documented.
  • Utilizing multiple online resources to detect, deter, and defeat fraud.
  • Providing investigative expertise to direct and conduct investigations.
  • Locating, extracting, analyzing, and organizing critical data from multiple systems to prevent and detect fraud
  • Ensuring the accuracy, quality, and timeliness of the evidence gathered.
  • Understanding applicable laws, legal codes, court procedures, precedents, government regulations, executive orders, and agency rules for effective investigations
  • Preparing and presenting completed investigations to appropriate senior staff and/or criminal justice personnel in a highly professional manner.
  • Providing superior communication, customer service and ensure relationship building with all integral personnel including Examiners, Risk Management, Auditors, Hearing Reps, Marketing, Underwriting, Claimants, Policyholders, Agents, Brokers, SIU, Legal and Medical professionals, Government/Regulatory Agencies, and Vendors.
  • Facilitating effective insurer communications with regulatory agencies.
  • Coordinating vendors to ensure appropriate outcomes and efficient pricing.

Required educational background and experience:

Bachelor's degree (B. A. or B.S.) from four-year college or university or equivalent combination of education and experience with a minimum 2-year college degree in criminal justice or insurance claim experience.

Working level knowledge of insurance and claim operations, commercial, personal, and Workers Compensation insurance products. 2-5 years SIU, legal, claims and/or law enforcement experience.

Private Investigator's License, Insurance Adjusting License, fraud related certificates (CFE, CIFI) recommended but not necessary given proper background experience in fraud investigation.

Additional skills that will help you succeed in this role:

Demonstrated abilities in: identifying persons or organizations involved in suspicious claims activities; working independently under minimal supervision; maintaining a strong work ethic and exercising initiative; communicating effectively both verbally and in writing.

Proficient in the use of a personal computer, including MS Word, MS Excel, MS Outlook and able to learn various proprietary computer applications.

Do you fit the profile? Contact us today to learn more about this exciting opportunity!

Company

 

ICW Header

 

Headquartered in San Diego, ICW Group is a multi-line insurer that provides coverage solutions to businesses through a network of independent agents and brokers. ICW Group offers three types of insurance—workers' compensation, earthquake and auto insurance. Known for meeting the needs of its policyholders, ICW Group prides itself on providing service that is truly customer-centric. In recent years, ICW Group has earned a reputation for helping policyholders achieve fewer and less costly claims. The company accomplishes this through extensive risk management expertise, highly proactive claims handling, and aggressive fraud monitoring.

At ICW Group, our focus and passion is offering great insurance products, services and experiences. We honor our commitments to our customers, our communities and each other to ensure that you have a better today and a safer tomorrow. With our home office in sunny San Diego, CA and with 10 branches across the U.S., ICW Group has over 40 years of experience in property and casualty insurance. Our passionate and creative team members are the power behind our successful business. 

A strategic investment in innovation today is critical to our success in the future. Our leaders welcome people who are eager to bring the power of innovation, the willingness to try something different or adopt a new approach or technology as we evolve to meet the needs of our customers and agents. Our culture fosters experimentation in models, processes, and products in an effort to move forward and help shape not only ICW Group’s future but the insurance marketplace as a whole. 

ICW Group is committed to the satisfaction of our customers and recognizes that satisfied, contributing Team Members are the foundation of a superior customer experience. With a team of 880, our enterprise is sized just right to provide broad challenging job responsibilities in a more personal environment. An important part of this personal approach to your success is our commitment to health and wellness. We provide a comprehensive program to help you maintain your total health because we believe that being at your personal and professional best is important to you and your family. 

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