Siu Specialist

Position Summary

Investigate possible fraud in underwriting and claims. May include medical provider fraud.

Essential Functions

• Investigate possible fraud in underwriting and claims.
• Provide monthly statistics, such as the number open and closed claims/underwriting files, as well as Special Investigations Unit Savings.
• Perform database searches and gather relative information needed from claims and underwriting files to commence an investigation.
• Conduct non-customer contact investigation, such as obtaining Department of Motor Vehicles certified copies and performing NJ court research.
• Prepare detailed and thorough reports on the findings of the preliminary investigation and make recommendations for further handling of the file.
• Prepare BFD forms for Investigators and meet with BFD Investigators on referred SIU files
• Communicate to the Supervisor any Special Investigations Unit issues from the claims and underwriting staff.
• Conduct customer contact investigations; take recorded statements; daily telephone contact with claimants, insureds, attorneys.

Physical Demands

• Prompt and regular attendance
• Frequently move about to coordinate work
• Must be able to be stationary and type for extended periods of time
• Frequently communicates with others in person, on the phone and in writing
• Lift and carry files weighing up to 5 pounds

Nonessential Functions

• Maintain SIU Database
• Assist with SIU Training Program

Education: Bachelors degree with at least 1 yr insurance experience; or Associates degree with at least 2 yrs insurance experience.

Years/Type of Experience: If no degree, then a minimum of 4 years related insurance exp.; or 5 years law enforcement exp. with 1 year insurance experience.

Licenses/Designations: Relevant insurance industry licensing preferred.

Specific Skills: Computer proficiency, detail-oriented, decision-making ability and strong communication skills. Must possess strong writing and reporting skills.

Knowledge: Auto Insurance Underwriting Knowledge Needed. Claims Knowledge a Plus.