We are looking to hire a SIU Desk Investigator in the Los Angeles Metro, CA area. As a dedicated SIU Investigator, you will within defined guidelines and framework, protect USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. Responsibilities include applying knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third party claims; participating in the development of fraud prevention strategies; applying knowledge of P&C insurance industry products, services, and processes in investigating claims including P&C insurance policy contracts, coverages and internal claims handling process and procedures; applying knowledge of state laws and regulations pertaining to insurance fraud in investigating claims; collecting evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools; making recommendations within defined authority guidelines; preparing and presenting detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome; developing and maintaining external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention; serving as a resource team member on specific matters through demonstrated skill or training; assisting with the delivery of fraud awareness training initiatives in a defined environment; handling CAT duty responsibilities as business requires; ensuring risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. Requirements include a High School Diploma or General Equivalency Diploma; 2 years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4 years prior investigative law enforcement (including military) or relevant fraud industry investigation experience; proven investigatory skills; experience obtaining statements from various parties to incidents, witnesses, and suspects; ability to gather broad range of evidence and draw conclusions based on objective details related to the applicability of fraud; proven ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems; familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems; knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology. Preferred qualifications include SIU Desk experience; P&C experience including Auto, Property and Underwriting; current or prior SIU investigations experience working in diverse teams across multiple functions within SIU.
By applying, you consent to your information being transmitted by Jooble to the Employer, as data controller, through the Employer’s data processor SonicJobs.
See USAA Privacy Policy at and SonicJobs Privacy Policy at and Terms of Use at
...and employees. We never forget that we provide care and comfort to people in need. Rolling Hills Hospital is looking for a dynamic customer service focused Receptionist to join our team. The Receptionist facilitates the flow of organization information while providing...
...their care team consisting of care promoter (medical assistant), care facilitator, and care... ...for patients able to come to the office. For patients that are unable to come... ...available, based on guidance from Market Chief Medical Officer. Fills in as needed for center...
...resources, tools, and projects across RTL for the broader campus community.Job SummaryThe Assistant Vice Provost for Undergraduate Education and Chief Academic Technology Officer (CATO) is the strategic leader who provides vision and direction at the intersection of...
.... As the leader in physical, occupational, speech, and respiratory therapies... ..., plus our Journey Travel Program lets you work across... ...collaboration with licensed therapists, the Clinical Operations Area... ...of progressively responsible OT experience. * They must have...
...teamwork, growth, and professional development. Were expanding and seeking motivated individuals to join our dynamic team of Appointment Setters. If you thrive in a fast-paced environment, enjoy engaging with people, and are passionate about helping others, wed love to...