Job Description

We are looking to hire a SIU Desk Investigator in the Los Angeles Metro, CA area. As a dedicated SIU Investigator, you will within defined guidelines and framework, protect USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. Responsibilities include applying knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third party claims; participating in the development of fraud prevention strategies; applying knowledge of P&C insurance industry products, services, and processes in investigating claims including P&C insurance policy contracts, coverages and internal claims handling process and procedures; applying knowledge of state laws and regulations pertaining to insurance fraud in investigating claims; collecting evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools; making recommendations within defined authority guidelines; preparing and presenting detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome; developing and maintaining external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention; serving as a resource team member on specific matters through demonstrated skill or training; assisting with the delivery of fraud awareness training initiatives in a defined environment; handling CAT duty responsibilities as business requires; ensuring risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. Requirements include a High School Diploma or General Equivalency Diploma; 2 years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4 years prior investigative law enforcement (including military) or relevant fraud industry investigation experience; proven investigatory skills; experience obtaining statements from various parties to incidents, witnesses, and suspects; ability to gather broad range of evidence and draw conclusions based on objective details related to the applicability of fraud; proven ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems; familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems; knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology. Preferred qualifications include SIU Desk experience; P&C experience including Auto, Property and Underwriting; current or prior SIU investigations experience working in diverse teams across multiple functions within SIU.

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