SIU Investigator Position Available In Greenville, South Carolina
Tallo's Job Summary: The SIU Investigator role involves conducting in-depth investigations on potentially fraudulent claims, ensuring SIU compliance, and collaborating with various departments to prevent fraud. Qualifications include a bachelor's degree or equivalent experience, a minimum of three years investigating fraud, and advanced knowledge of SIU laws. The position requires strong computer skills and occasional travel with around-the-clock accessibility during investigations.
Job Description
SIU Investigator Job Summary:
The Special Investigation Unit (SIU) Investigator position is responsible for performing and/or coordinating activities in the investigation of incidents involving suspected fraud. The position is also responsible for insuring that the Company complies with all SIU regulations promulgated by the various insurance departments.
Major Accountabilities:
1. Conduct in-depth investigations related to potentially fraudulent claims while validating meritorious claims. 2. Understand all facets of claims processes to a working level and be able to manage multiple priorities and peak workloads. 3. Supervise and monitor activities of outside Special Investigation vendors during the investigation of the claim. 4. Work with UW, Accounting, and all business units to identify potential fraud, uncover opportunities to prevent leakage and mitigate loss. 5. As needed perform background and asset checks on individuals and businesses. 6. With SIU team conduct company-wide SIU training. 7. Perform other duties as assigned by Management.
Qualifications:
Education/Training Requirements:
Bachelor or commensurate experience required.
Experience/Specialized Skills:
Minimum three investigating potentially fraudulent activity and/or fire and theft claims required. Advanced knowledge of SIU compliance laws and regulations required. Familiarity with basic insurance law, understanding of basic legal principles and terminology as it relates to insurance operations and knowledge of medical terminology and procedures required. Intermediate computer skills (word processing, spreadsheets, databases, Internet, e-mail) required.
Special Considerations:
Physical Requirements:
Constant use of vision, hearing, and communication (oral and written in person and via telephone). Frequent concentration, standing, walking, handling, reaching, and grasping. Occasional bending, kneeling and lifting (up to 25 lbs.) Heavy use of computer and office equipment.
Travel/Hours of Service:
Occasional travel required. Around-the-clock accessibility during on-going investigations is required. Periodic work outside of standard business hours or on weekends required.
