The SIU Specialist will be responsible for working with dedicated SIU clients and assist in identifying suspected fraud claims, reviewing claim documents, developing and recommending investigative actions, and conducting field investigation. The position is home based and involves working in the field up to 70% of time conducting complex investigations and/or providing SIU Consulting in a client’s office. The SIU division encompasses complex claims investigations, suspicious and fraudulent claims investigation, reports to and coordination with law enforcement or state fraud bureaus for regulatory compliance and criminal prosecutions, and corporate investigations. The SIU also conducts training sessions for adjusters, supervisors and other staff on anti-fraud and claim related topics. The SIU Specialist will visit SIU client claims offices and provide assistance on suspect claims, and be engaged in providing fraud awareness training to adjusters, underwriters, and others.
Expert investigative consulting on designated SIU client claim files;
Field investigation on suspected fraud cases;
Technical direction to investigators on complex and SIU investigations;
Conduct Fraud Awareness and LOB specific training for client offices for
Continuing Educational Credits;
Assist with presentations of potential criminal cases to DA/DOI;
Ability to lead select field investigations in support of SIU clients;
Internal Training resource for G4S Investigators in their area;
Traveling in local region will be up to 70%.
Skills & Experience Required:
5+ years SIU experience, including developing, coordinating, packaging, and presenting investigations and prosecutions of suspected fraudulent insurance claims, and related criminal acts, with state DOI Fraud Bureaus, law enforcement, and state/federal prosecutors required.
10+ years law enforcement experience, with significant responsibility for criminal investigations and prosecutions. Law enforcement applicants MUST have insurance company SIU experience;
Multi-line experience preferred. Experience in handling complex claims and suspected insurance fraud investigations.
Strong interpersonal skills and expert interviewing skills;
Strong computer skills using Word, Excel, Power Point and Outlook. Ability to learn new software operating systems.
Bachelor’s degree required, and advanced degree preferred. Substantial insurance industry SIU management and technical investigative experience may be substituted for the formal education requirement.
Reports to the Regional Investigations Manager - SIU
For more information about G4S Compliance & Investigations, please view our web site at http://www.cni.g4s.com/
Please submit a resume and cover letter to: [Click Here to Email Your Resumé]
G4S Compliance & Investigations is an EEO employer fully committed to attracting, retaining, developing, and promoting the most qualified individuals without regard to race, religious creed, color, age, sex, national origin, ancestry, marital status, sexual orientation, disability or any other classification protected by applicable federal, state or local law. We are dedicated to providing and maintaining an inclusive work environment free from discrimination and harassment, where employees are treated with respect and dignity.
G4 Securicor-Justice Services - 13 months ago