To obtain, verify and analyze information, statements and records to determine if a questionable claim is fraudulent.
Essential Job Results:
% of Time
Results Expected and Duties Performed
Expedites resolution of suspicious claim by establishing scope, timing, and direction of investigations; interviewing witnesses, claimants and insureds; taking recorded statements; conducting Examinations Under Oath (EUO); inspecting clinics; conducting surveillance; canvassing neighborhoods; collecting police reports; reviewing vehicle inspections; recording evidence; analyzing records and information; communicating investigation results to all relevant parties.
Completes Proactive work by Utilizing antifraud technology, investigative and analytical strategy to identify potentially suspicious claims and drive SIU referrals.
Ensures legal compliance by conducting investigations within specified time line; documenting procedures and findings; keeping abreast of company policies, industry trends and state regulations.
Maintains quality service by proactively communicating with adjusters; collaborating with other departments in order to exchange information and coordinate activities; returning calls in a timely manner.
Required behaviors for all positions :
Communicate with co-workers, management, customers, vendors, and others in a courteous and professional manner
Conform with and abide by all Company codes, regulations, policies, values, work procedures and instructions
Education : High school or equivalent required. College degree preferred.
Experience : Minimum 3-4 years claims experience in the auto insurance industry. Minimum 2 years investigative and surveillance experience.
Skills and Abilities : Excellent verbal and written communications skills. Ability to effectively manage own time and coordinate various tasks simultaneously. Effective investigative and interviewing skills. Ability to analyze information and evaluate results in order to choose the best solution and solve problems. Ability to work under minimal supervision. Ability to remain calm in difficult situations.
Other : Bilingual (English/Spanish or English/Creole) preferred.
Travel : 40%-50%
Compensation : Competitive Salary based on experience. Excellent benefits package: medical, dental, vision insurance, life insurance, short term and long term disability insurance, 401K, Paid Vacation and Holidays.
All offers are contingent upon a background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO. EOE.
Gainsco Auto Insurance - 11 months ago
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