SIU Claims Analyst - Associate (Property Insurance)

Company Description

Searching for a place to make your mark? Every great team depends on the individual contributions of its members – the skills, talents and the passion that each team member brings. At Citizens, we’re building a workforce of top achievers committed to our company’s mission and vision. Our company values the knowledge that comes from experienced and dedicated individuals with a variety of backgrounds, in or out of insurance.

Citizens’ Mission is to provide Property Insurance protection in Florida to those who are, in good faith, unable to obtain coverage through the private market while also providing the utmost in customer service. Our Values are public service, integrity, respect, responsiveness and sound judgment. We strive to not only provide affordable insurance products and services but also to provide sound financial responsibility to the citizens of Florida.

 At Citizens, we are a team of dedicated, service-minded professionals committed to our policyholders. Come achieve and maximize your potential with us!

Job Description

The primary purpose of this position is to support Citizens’ SIU by providing analysis, basic research, and data feedback utilizing existing predictive model and AI systems; channeling such alerts to investigative team to investigate potential fraudulent conduct impacting claims, underwriting and agency markets.

ESSENTIAL FUNCTIONS:

• Models ethical behavior and executes job responsibilities in accordance with Citizens core values, ethics, and information protection policies.
• Monitor real time queues and identify high risk alerts for SIU referrals. Assign queued alerts within the service level agreements to various SIU teams and increase the number of potential fraudulent referrals for further investigation.
• Review and analyze large volumes of predictive Claims and Underwriting alerts for potential fraud, resolve queued transactions within the service level agreements to reduce potential revenue losses.
• Assist with the implementation of new processes and software solutions, identify system improvements to prevent further fraudulent activities and maintain fraud analysis models to improve efficiency and effectiveness of the predictive systems.
• Gather data, compile reports, and analyze reports to identify fraud trends or ring activity.

Qualifications

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

• Proficiency with fraud detection software and tools.
• Immediate Investigative experience reviewing claim files and or underwriting experience.
• Demonstrated knowledge of working Triage queues.
• Demonstrated knowledge of BI.
• Intermediate experience/knowledge with reporting, visualization, data modeling and hands on with Power BI, SQL, Database concepts.
• Demonstrated knowledge of IT audit, data analytics, as well as investigation processes and methodologies.
• Prior experience with risk analysis, risk management.
• Investigative and Creative problem-solving abilities and strong organizational skills.
• Ability to conduct basic research of public records and proprietary databases for material information impacting a claim or policy.
• Demonstrate the ability to exercise judgement when making decisions.

REQUIRED EDUCATION AND EXPERIENCE:

• High School Diploma or Equivalent
• Bachelor’s Degree OR 4 years relevant experience, OR a combination of college education and relevant experience equivalent to 4 years

AND

• 3-5 years of experience in P&C or related Fraud Investigation and/or Analytics background preferred.

PREFERRED QUALIFICATIONS:

• Bachelor’s degree (preferred).
• Investigation experience with established workflows and hands on reviewing the claims files.
• Knowledge of Fraud Analytics Software and/or Fraud detection methodologies.
• Knowledge of MS Office Suite Products.

PHYSICAL REQUIREMENTS:

Requires the ability to sit for long periods of time listen and converse over the telephone and frequently type on a computer (4 or more hours per day).

 

Additional Information

We offer unlimited career potential, excellent training and development opportunities, and a structured Career Development program to explore future roles of interest while growing and developing in your existing role.

Citizens offers a competitive compensation and benefits package that includes comprehensive medical/dental, Retirement Savings Plan, Vacation and Sick Time, EAP, Tuition Reimbursement, Community Service and much more!

·         Retirement savings plan with a generous company match

·         Medical, dental and vision coverage

·         Company Paid employee basic life insurance and short-term disability

·         Generous paid time off: vacation, sick and holiday leave

·         Employee Assistance and Wellness Programs

·         Tuition reimbursement

·         Professional and leadership development opportunities

·         Flexible work schedule and Alternative Work Arrangements

·         Company Paid Parking

·         Employee recognition programs

·         Relocation assistance (where applicable)

·         Community and volunteering opportunities

·         Casual dress

Citizens is Proud to Be an Equal Opportunity Employer

Visa sponsorship is not available for this position.