The SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. Our Special Investigator will function as a remote investigator working from her/his residence and servicing the Los Angeles, CA and surrounding areas. Basic functions include: Investigation of claims, analysis and development of facts and evidence, and conducting and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement agencies. A laptop computer, cell phone and digital camera, MP3 recorder and other office equipment will be provided. Applicants must have the ability to travel.
Position Responsibilities:
Attends necessary training schools and participates in training to develop and improve skills, develops contacts and meets state regulatory educational requirements.
Investigates files by using appropriate field, computer and telephone investigative techniques and provides appropriate documentation of actions in a thorough timely manner.
Maintains a diary system on all assigned files. Diary system is to be worked so that the tempo is sufficient to assure prompt and timely recommendations.
Prepares necessary reports for state fraud bureaus and cooperates with state agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised of all critical situations.
Reports findings of all investigations and makes recommendations to the responsible manager or other designee in a timely manner so as to facilitate prompt decisions.
Develops and maintains contacts with other special investigative units and fraud related organizations.
Acquires and maintains current knowledge in all appropriate jurisdictions regarding changes in law to ensure operations are within proper parameters established by law.
Position Qualifications:
College Degree or equivalent work experience.
Three years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or
Five years of professional investigation experience involving economic or insurance related matters; or an authorized medical professional to evaluate medical related claims.
Must have a working knowledge of Digital photo and document metadata and have experience with using the internet and social networking for investigative purposes.
The candidate must possess knowledge of the principles of casualty insurance and the auto casualty claims adjustment process.
Investigative and legal expertise needed for this position.
Completion of the NICB Basic and/or Advanced Academies and the Reid Interviewing and Interrogation Courses are desirable.
Must have excellent communication skills and thorough working knowledge of Microsoft office applications.
Must demonstrate a thorough knowledge of the workings of related state and federal agencies. The SIU investigator must possess oral and written communications skills and promote a favorable company image to the public.
Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are preferred.
A valid drivers license and clean driving record is required.
