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

Gpac

Head of Renewals, Real Estate Job at Gpac

Head of Renewals, Real Estate gpac , a professional search firm with over 30 years in the recruitment industry, is pleased to partner...  ...and Marketer with a well-established career in the Commercial Renewal space. Extra points if your market is in Real Estate... 

Yale New Haven Health

Registered Nurse RN - Transitional Care Coordinator Job at Yale New Haven Health

 ...professionals, every day.Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans,...  ...Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.EEO/AA/Disability/VeteranResponsibilitiesAssesses... 

Rob Job Video

Remote Concept Artist Job at Rob Job Video

 ...sinister on closer inspection - grounded in real-world materials (fabric, foam, seams) Deliverables would include a small number of concept illustrations to hand off to SFX fabricator. How to Apply Please email ****@*****.*** with work examples. Thank you!... 

Feed My Starving Children

Systems Administrator Job at Feed My Starving Children

 ...Your Role: Serve as the Systems Administrator for Feed My Starving Children (FMSC). Support our mission to feed children worldwide by ensuring...  .../hybrid work schedule that allows for both office and remote work. Reports to IT Director. FMSC is an equal opportunity... 

IDS International

Cleared American Guard (TS Clearance Needed) Job at IDS International

 ...Job Title Cleared American Guard Why IDS? IDS believes in resolving conflict, building innovative approaches to do so. Combining operational expertise with an intimate understanding of todays greatest challenges, we bring our customers the solutions required for...