Claims / SIU Investigator

San Diego, CA, United States

Job Description Job Description Overview Allied Universal Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance company, provides rewarding careers that give you a sense of purpose. While working in a dynamic, diverse and inclusive workplace, you will be part of a team that fuels a culture that will reflect in our communities and customers we serve. We offer medical, dental and vision coverage, life insurance, retirement plan, employee assistance programs, company discounts, perks and more for most full-time compliance and investigation jobs!

Job Description Allied Universal is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that suggest fraudulent behavior In relation to an Insurance claim. The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution.

Job flexibility offering field and remote work!!!

Auto Allowance and Company Credit Card for fuel and travel!!!

Will require Claims and Surveillance investigations as needed to ensure a full schedule

RESPONSIBILITIES:

Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability

Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance

Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed

Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct

Run appropriate database indices if necessary and verify the accuracy of results found

Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor

QUALIFICATIONS (MUST HAVE):

Must possess one or more of the following:

Bachelor's degree in Criminal Justice

High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud

Ability to be properly licensed as a Private Investigator as required by the state where work Is completed

Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course

Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims

Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area.

Proficient in utilizing laptop computers and cell phones.

Special Investigative Unit (SIU) Compliance knowledge

Ability to type 40+ words per minute with minimum error

Flexibility to work varied and irregular hours and days including weekends and holidays

PREFERRED QUALIFICATIONS (NICE TO HAVE):

Military experience

Law enforcement

Insurance administration experience

Familiarity with California SIU regulations

One or more of the following professional industry certifications:

Certified Fraud Investigator (CFE)

Certified Insurance Fraud Investigator (CIFI)

Fraud Claim Law Associate (FCLA)

Fraud Claim Law Specialist (FCLS)

Certified Protection Professional (CPP)

Associate in Claims (AIC)

Chartered Property Casualty Underwriter (CPCU)

BENEFITS:

Pay Rate: $25 - $30 / hr

Medical, dental, vision, basic life, AD&D, and disability insurance

Enrollment in our company's 401(k)plan, subject to eligibility requirements

Seven paid holidays annually, sick days available where required by law

Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.

Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have any questions regarding Equal Employment Opportunity, Affirmative Action, Diversity and Inclusion, have difficulty using the online system and require an alternate method to apply, or require an accommodation at any time during the recruitment and/or employment process, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.

Requisition ID2024-1232458

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