SIU Investigator Job at Delta Group, Portland, OR

RmJPY0NnQ0RKMndWd21QeHlvVzZlSEZpRHc9PQ==
  • Delta Group
  • Portland, OR

Job Description

The Special Investigation Unit of Delta Group investigates and identifies questionable and suspicious claims for our partners, communicating with claims personnel, insurance carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and deter fraud. The candidate should have extensive experience with claims for all lines of insurance, with a heavy emphasis on Workers’ Compensation claims.

JOB DUTIES:

  • Conduct timely investigations including recorded statements and interviews of claimants, witnesses, and employers.
  • Provide timely status updates to case manager and client.
  • Timely and clear documentation of the claim files.
  • Maintain highest level of confidentiality and professionalism.
  • Develop appropriate investigative action plan.
  • Ensure accuracy, quality and timeliness of the evidence gathered during an investigation as well as compliance with all applicable laws, legal codes, and governing agencies.
  • Provide Claim Adjuster with timely investigation results and document investigative findings.
  • Determine whether additional evidence is required including but not limited to accident reports, accident scene reconstructions, witness statements, police reports, expert opinion, etc.
  • Provide recommendations and decisions surrounding investigative efforts.
  • Perform detailed database queries on SIU investigations to include analysis and organization of critical data to assist during the assigned investigation.
  • Be able to evaluate State compliance referrals, as applicable, when questionable or suspicious activity is identified.
  • Maintain active membership in professional organizations that provide SIU assistance and resources.
  • Establish and maintain relationships with law enforcement, government regulatory agencies and insurance industry personnel assisting when needed or required.

JOB REQUIREMENTS:

  • Strong investigative skills necessary.
  • Must be detail oriented.
  • Ability to recognize patterns of inconsistencies that may be linked to fraudulent activity.
  • Must have ability to interact with clients, repair shops and appraisers, and employers.
  • Ability to work independently.
  • Excellent verbal and written communication skills.
  • Good organization and time management skills.
  • Demonstrate knowledge of tools and techniques needed for conducting insurance claims investigations.
  • Demonstrate proficiencies with computer software, Word, Excel, Outlook and Teams.
  • Must have the ability to utilize an objective perspective when performing tasks.

EQUIPMENT NEEDED:

  • Laptop Computer
  • Cell Phone
  • Audio Recording device with download capability
  • Digital Camera
  • Tape measure

EDUCATIONAL REQUIREMENTS:

  • CFE or FCLS designations preferred
  • 5-10 years’ experience in claims and SIU investigations preferred

Job Tags

Similar Jobs

Phillips 66

Maintenance Technician, Permian Area Midstream Job at Phillips 66

 ...materials and equipment in a cost-effective manner. Dispatches field crews engaged in the construction, maintenance, and emergency...  ...more years of experience in Maintenance and Construction in the oil and gas industry ~ Valid driver's license ~ Willing and able... 

Path Environmental Technology LLC

Process Operator Job at Path Environmental Technology LLC

 ...Summary The Process Operator is responsible for performing physical labor and monitoring equipment and process variables in order to assist in project processing operations. Field tasks include fueling, cleaning, maintaining and monitoring of process equipment housed... 

Brandcoven

Data Entry Clerk I Job at Brandcoven

 ...Position: Data Entry Clerk Location: Remote, United States Job Type: Part time/Full time Company Overview: Brandcoven is a leading marketing and branding agency that specializes in helping businesses build their brand and reach their target audience... 

Royal Star Realty

Data Entry Clerk Job at Royal Star Realty

 ...a detail-oriented and dependable Remote Data Entry Clerk to support our administrative and...  ...Process forms, documents, and reports in a timely manner Follow data confidentiality and...  ...Job Details Job Type: Full-Time or Part-Time Work Location: Remote (Work from... 

Palmetto General Hospital

Certified Registered Nurse Anesthetist -CRNA, Surgery -OR, Full Time, Flex Shift, Job ID 1576924, 20k SIGN ON BONUS - Palmetto General Hospital - Hialeah, Florida, United States Job at Palmetto General Hospital

20k SIGN ON BONUS Job Summary: Palmetto General Hospital is seeking a highly skilled and compassionate Certified Registered Nurse...  ...initiatives, and continuing education. Adhere to hospital policies, state and federal regulations, and professional standards....