SIU Investigator

Published
May 12, 2020
Location
Alpharetta, GA
Job Type

Description

We are currently looking for an SIU Adjuster to join our team. You must have a current adjusters' license, with a FL All Lines License to be acquired immediately. Additional licensing a plus. Also, you must have a valid driver’s license.

The SIU Adjuster position will report to the SIU Manager. This is an SIU position in which the candidate will be responsible for SIU insurance investigatory and compliance matters, specifically in the following daily duties:

  • Review referred claims to determine if SIU investigation is warranted
  • Assign claims to and manage SIU vendor assignments for surveillance, investigations, EUOs, medical canvass
  • Assist with SIU Annual, New Hire and Ongoing Training
  • Assist with SIU State Fraud Reports and Audit responses
  • Provide comprehensive SIU fraud referrals to the appropriate state and local law and insurance officials
  • Attend industry meetings and liaise with state fraud investigators and law enforcement as needed
  • Assist in maintaining and updating Anti-Fraud documentation as needed
  • Assist in tracking state requirements and communicating to the company
  • Serve as backup to SIU Manager during absences
  • Work with other insurance companies and law enforcement in sharing privileged file materials
  • Conduct desk investigations including background checks and social media, utilizing technology aids such as ISO, Accurint, and others
  • Assist other insurance carriers in immunity (FL section 626) requests for file/investigative materials
  • Ensure compliance personally and by our adjusters with NARS SIU and Claims Best Practices
  • Assist with development of our claims system to include data gathering and predictive modeling
  • Assist coworkers with daily activities as needed
  • May conduct field inspections to include in-person interviews, scene or vehicle inspections, canvasses for witnesses, Examinations Under Oath (EUO's) and meetings with law enforcement and experts
  • May directly handle some low impact and other fraud claims, and assist in direction of other adjusters in managing these claims.
  • Assist and cooperate with clients as necessary in supporting investigations, referrals, and other matters
  • Adhere to all file handling standards, NARS Best Practices, Client standards, state statutes and requirements necessary to pass audits performed by regulatory agencies, carriers and clients
  • Maintain strict confidentiality of client, company and personnel information
  • Track industry state or regional fraud trends. 
  • Know the Team’s Clients and be able to confidently discuss their claims
  • Participate in development and implementation of training programs
  • Maintain knowledge of current industry developments, case law changes and best practices.

 

Bachelor's Degree preferred, or substantially equivalent experience. 3 + years of adjusting, legal, management, and/or SIU experience required, multiple lines of business preferred.

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