Directs and conduct assigned SIU investigation's to final disposition.
Work closely with members of Claim, Underwriting, Premium Audit, Program Administrators and Claim Support Staff to promote fraud interdiction efforts.
Assign, directs and control outside vendors to ensure cost-effective investigations.
Monitor and evaluate vendor activity to ensure high standards of performance.
Liaison with Departments of Insurance, law enforcement and other SIU representatives to ensure a continuing investigation and prosecution of suspect cases.
Report all suspect cases to the designated agencies (DOI's IFB's, Law Enforcement, NICB, etc) to ensure compliance with applicable statutory reporting requirements.
Utilize internal and external resources, provides fraud interdiction training and identify staff developmental needs from a fraud educational perspective.
Some travel will be required.
- High School Diploma required, NICB Nat. Academy and/or college degree is preferred.
- CIFI-CFE-FCLA-FCLS-SCLA or AIC designations preferred.
- Minimal five years prior insurance industry claim or SIU experience.
- Strong investigative, organizational and communication skills.
- Experience working within a fixed Claim Department office environment preferred. .
- Expertise in developing and maintaining case management spreadsheets.
- Operational knowledge of ISO, NICB, public record databases and internet data-mining.
Everest is committed to recruiting and retaining the most talented individuals in the industry.
Everest offers a dynamic work environment and a competitive compensation and benefit package; which includes a 401k plan, retirement/savings option, tuition reimbursement, medical, dental, vision, life and group legal plans.
We are an Affirmative Action/Equal Opportunity Employer. All considered applicants must be eligible to work in the U.S. with unexpired, acceptable employment eligibility verification documentation.
Everest Re Group, Ltd. - 18 months ago