Our Company
At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate has the opportunity to learn and grow. We strive to create a work environment to meet associate needs and we are determined to achieve excellence in everything we do.
This is an opportunity to join a dynamic team in a company that is a leader in the non-standard auto insurance space and functions with a small company, entrepreneurial style. This position will require someone with an understanding that one needs to have a “roll up your sleeves” attitude to help make things happen.
Job Summary
A Special Investigations Unit (SIU) Desk Investigator within an insurance company plays a crucial role in assisting the SIU and claims departments with fraudulent activities related to insurance claims.
The Desk Investigator conducts low to moderate investigations involving suspicions of insurance fraud related to the application of insurance, auto/property, and injury claims. The Desk Investigator plans, prioritizes, and executes investigative assignments, including backgrounds, interviews, and Examinations Under Oath.
The Investigator is responsible for analytical review of suspicious claims utilizing various investigative methods and techniques. The investigator must evaluate relevant information essential in resolving suspicious and complex investigations. This position requires demonstrated effectiveness in the understanding and application of legal and claim principles. The Investigator should have a working understanding of coverage and or personal injury protection coverage.
This is an in-office position, and only candidates currently living in the greater Tampa area will be considered. Relocation assistance is not available for this position.
Job Responsibilities
The primary role of the desk investigator will be to conduct Examinations Under Oath, and report the findings of same.
Claims Investigations to include but not limited to: statements, document analysis/verification, damage analysis
Provides office training to ensure recognition of potentially suspicious or fraudulent files in the branch
Must ensure compliance with industry and company policies
Must understand regulatory / statutory requirements; develops and maintains knowledge of changes in law both at state and national levels
Properly utilizes our claims and other various systems
Attends industry meetings to identify industry trends
Completes individual weekly Investigator report to manager
Attends and participates in team meetings, roundtables
Actively affiliates and maintains network of SIU, claims, law enforcement, attorney, and related contacts to ensure investigation methods are current and proper operating procedures are utilized
Responsible for meeting individual goals and objectives
Maintains consistent, fair, and diplomatic interactions with co-workers
Performs other duties as assigned by SIU Manager
Formal Education & Certification
Bachelor's degree in criminal justice, finance, business administration, or related field.
Previous experience in insurance claims investigation, fraud detection, or law enforcement helpful.
Excellent communication and interpersonal skills, with the ability to interact effectively with diverse stakeholders.
Attention to detail and ability to maintain confidentiality when handling sensitive information.
Proficiency in relevant software applications for data analysis and documentation.
Knowledge of insurance laws, regulations, and industry standards related to fraud investigation.
Knowledge in medical terminology, medical billing, CMS 1500 forms helpful
Florida Insurance Adjusters License required within 90 days of employment
Experience
2 years of prior SIU Investigator or claims handling experience. Must have a working understanding of coverage and requirements of personal auto policies and or personal injury protection coverage.
Skills & Competencies
Insurance Knowledge: A solid…