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

Insight Global

Assistant Property Manager Job at Insight Global

Job DescriptionInsight Global is searching for an Assistant Property Manager to join a dynamic property management team supporting multiple commercial properties in South San Francisco, CA. This role is ideal for candidates with strong organizational, financial, and communication... 

EquipmentShare

Business Intelligence Analyst Job at EquipmentShare

 ...Future Business Intelligence Analyst Opportunity with EquipmentShare! EquipmentShare is accepting applications for future Business Intelligence Analyst openings in the Columbia, MO area. At EquipmentShare, were always looking ahead - and that means continuously... 

CalOpps

Police Officer (20674205) Job at CalOpps

 ...Description The City of Wheatland is accepting applications for Police Officer and/or lateral.POLICE DEPARTMENTThe Wheatland Police Department is responsible for providing public safety for the city.Services provided by the Police department include uniformed... 

GradePower Learning Centers

Elementary Reading & Math Teacher Needed! Job at GradePower Learning Centers

 ...Part-Time Elementary Teacher/Tutor Wanted Excited by literature and math? Eager to help elementary students succeed in these subjects? We are currently seeking...  ...to commute to this location . This position has an online component. Relocation packages are not available.... 

Lynn Community Health Center

Primary Care Nurse Job at Lynn Community Health Center

 ...Summary Primary Care Nurse (RN/LPN) provides patient care within the ambulatory setting, utilizing assessment and teaching skills to foster patient health. The PC Nurse tracks patients at risk, collaborates with medical providers, performs POC testing, administers...