The position is responsible for conducting in-depth field investigations of suspicious property insurance claims in a personal lines and commercial lines environment. This includes the investigation of low to moderately complex, suspicious or unlawful activity directed at policyholder and corporate assets in a prompt and expeditious manner. Incumbents in this level are expected to be fully qualified and competent to perform insurance claim investigations.
ESSENTIAL FUNCTIONS: THE FOLLOWING ARE THE USUAL, BASIC AND ESSENTIAL FUNCTIONS OF THE POSITION. THESE FUNCTIONS ARE NOT TO BE CONSTRUED AS AN EXHAUSTIVE LIST OF ALL RESPONSIBILITIES, DUTIES, AND SKILLS REQUIRED.
- Models ethical behavior and executes job responsibilities in accordance with Citizens core values and ethics policies.
- Independently investigates claims involving suspicions of insurance fraud and other irregularities in accordance to Citizens Property Insurance Corporation’s core performance values and best practices; conducts low to moderately complex investigations with minimal directions.
- Prioritizes assignments and conducts necessary field work; exercises independent judgment, initiative and decision making when performing investigations.
- Analyzes facts and data, conducts recorded interviews, prepares investigative reports, and recommends investigative direction to claims adjusters and managers as appropriate.
- Provides support to claims partners and other departments of the corporation, which may include identifying training needs; participation in developing and presenting training and mentoring of external business partners and internal staff to raise fraud awareness and invigorate quality SIU referrals.
- Regularly attends/initiates meetings with claims management. Keeps management informed of developments that impact claims results in assigned region / territory.
- Develops and maintains industry, federal, state and local government contacts involved in fraud investigation, detection and prevention.
- Maintains and pursues technical competency continuing fraud education within area of specialization through insurance fraud seminars and other company sponsored courses at the direction of Special Investigations Unit Leadership.
- May participate in catastrophe response event.
- Performs other essential duties as assigned.
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:
- Ability to work independently with minimal supervision and manage a high volume of assignments
- Strong analytical, verbal and communication skills
- Time Management / Self Motivated
- Co mputer skills
- Customer Service and relationship/team building
- Analytical skills and ability to make deductions; logical and sequential thinker
- Knowledge of available resources (internal and external) to assist in investigations
REQUIRED EDUCATION AND EXPERIENCE:
- Two year degree in Criminal Justice/Corrections, business administration or related field or equivalent years in college education and experience relevant to position
- 4 plus years combined SIU/investigative experience and property/casualty claims experience
- Bachelor’s degree preferred
- Industry certification (CIFI, FCLS)
- Bilingual (English / Spanish)
- Comprehensive knowledge of interview and evidence gathering techniques
This position requires the ability to conduct field work on a regular basis and be able to work a flexible schedule. Ability to sit for long periods of time, hear and converse over the telephone, and key frequently on a computer. Position also requires the ability to be mobile, operate a motor vehicle, inspect physical damage and work in a highly energetic and flexible work environment. Position also requires ability to travel overnight on a limited basis .
Citizens Property Insurance Corporation - 15 months ago