Claims SIU Senior Investigator (remote opportunity)

Ready to be a part of our Team? Grange Insurance more than provides peace of mind and protection during life’s unexpected events. It’s a place for Associates to explore potential, think creatively and push the boundaries of innovation and success. Our culture thrives on collaboration and interaction — that mixed with our strategic plan have led us to achieve consistent, profitable growth, year over year. This is something we’re proud of and celebrate.

Summary: Responsible for conducting and overseeing investigations and supporting Grange anti-fraud initiatives.

What You’ll Be Doing:

• Analyzes, monitors, and conveys highly technical and at times sensitive information into actionable investigative strategies including the identification of complex case investigations.
• Disseminate relevant information regarding investigative techniques, practices, fraud trends and area alerts to internal customers and provide relevant investigative/fraud training.
• Assist the SIU management team as requested. This may include participation in audits, reviewing file closings, special projects, and assuming managers’ duties when needed.
• Work with SIU Leadership in developing, establishing, refining, and continually improving SIU best practices and strategies.
• Work with Claims LOB (AMD, Casualty, Property, Commercial and Workers’ Comp.) on developing and implementing investigation best practices and guidelines. Additionally, work in a collaborative effort with the Claims LOB and SIU Leadership to define success measures that can be reviewed, analyzed and trended for continual improvements to the process.
• Provide feedback to other departments (Profit Centers, General Counsel, Marketing, Underwriting, etc.) regarding relevant issues that affect the company’s business.
• Display advanced knowledge of investigative techniques, policy interpretation, civil and criminal proceedings, and laws relating to insurance.
• Review referrals from multiple sources (Claims, UW, Agents, fraud analytics, etc.) for investigative merit, identify those referrals with fraud indicators and conduct appropriate investigations.
• Provide education, training, assistance and direction to the file handler for further claims handling for referrals that do not meet the criteria for opening.
• Utilize technology (ISO; local, state and federal public records; social network sites, internal policy systems; available forensic examinations, fraud analytics, etc.) in the investigative process.
• Plan and conduct required investigations, to include interviews (insured’s, claimants, witnesses, agents) conduct scene or vehicle inspections, conduct canvasses for witnesses, meet with authorities and expert vendors, etc.
• Appropriate utilization of field claims staff or vendors to assist with in-person investigation needs.
• Prepare complete, detailed, and accurate narrative investigative reports in a timely manner.
• Participate in Claims Committee by preparing a summary of the investigation, conducting an oral presentation of the facts, and participate in the associated roundtable discussion with (Profit Centers, Claims and Legal).
• Oversee and direct investigations by investigative, forensic, or legal vendors and exercise expense control when utilizing same.
• Establish and maintain cooperative working relationships with local, state, and federal law enforcement, fire, and prosecutorial officials.
• Make individual case reports to appropriate agencies to meet compliance guidelines.
• Participate in area intelligence gathering meetings.
• Appear in court as company representative, as needed.
• Attending EUOs, either in person or via Zoom, with assigned Defense Counsel. Contribute appropriately, as needed by the Counsel.
• Participate in Large Loss/Legal Roundtables by preparing appropriate timeline and submitting proper proofs.
• Identify fraud trends in the industry and formulate a plan of action to combat discovered fraud.
• Create and deliver relevant fraud training to each LOB on a monthly, weekly, quarterly, or annual basis.
• Actively participates in industry fraud/trade association groups.

What You’ll Bring To The Company:

Bachelor's degree or equivalent education and experience, plus a minimum of five years applicable investigative experience in Claims Department, law enforcement agency, or other investigative organization is preferred. This will be a desk investigator position with an emphasis on Casualty claims. A working knowledge of investigative techniques, rules of evidence and court procedures and the ability to travel upon immediate notice needed. Must be able to develop and follow leads to a logical conclusion and plan and conduct interviews of witnesses, insured’s or claimants to obtain information and evidence. Must possess the ability to maintain multi-case workload and adjust priorities as needed. Must possess excellent interpersonal, verbal and written communication skills. State specific adjusters’ license may be required.

About Us:

Grange Insurance Company, with $3.1 billion in assets and more than $1 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia and Wisconsin- the 13-state Grange Enterprise holds an A.M. Best rating of "A" (Excellent).

Who We Are:

We are committed to an inclusive work environment where we welcome and value diversity and inclusion. We hire great talent from a wide variety of backgrounds, and our associates are our biggest strength. The diversity of our associates, their backgrounds, experiences, and individual differences are the foundation for our success. Our inclusive culture empowers all of us to “Be One Team”, “Deliver Excellence”, “Communicate Openly”, “Do the Right Thing”, and “Solve Creatively for Tomorrow”. We have active Associate Resource Groups and a Diversity and Inclusion Team, that focuses on professional development, networking, business value and community outreach; all which encourage and facilitate an environment that fosters learning, innovation, and growth. Together we use our individual experiences to learn from one another and grow as professionals and as humans.

We welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender stereotyping, gender identity or expression, genetic information, ancestry, pregnancy, veteran status, and citizenship.

Grange Enterprise is proud to be part of the CEO Action for Diversity and Inclusion™, a national initiative of more than 1400 CEOs working for the advancement of diversity and inclusion within the workplace.