SIU Field Investigator
Plymouth Rock Assurance

Job Info

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The SIU Field Investigator is responsible for the accurate detection and in-depth investigation of potentially fraudulent insurance activity, ranging from complex medical and staged accident claims to simpler application fraud issues. Investigative activities will include in-person interviews and recorded statements. The SIU Field Investigator will prepare and present reports of impartial results to management for decision-making. You will work 100% in the field and coordinate efforts with industry fraud units, claim personal, counsel, law enforcement and agencies. You may provide evidence and testimony in cases where law enforcement agencies pursue prosecution. You may conduct fraud awareness training and/or investigate research.

This individual will work 100% in the field and will be provided with a company issued computer, phone and vehicle.
Responsibilities

Essential Functions and Responsibilities

• Prioritize and handle multiple tasks simultaneously. Adjust to fluctuating workload.
• Good file analyses/decision making when reviewing file documentation.
• Maintain diary to meet requirements for status reports on all investigations.
• Successfully completes investigation addressing all referral issues.
• Attend three days of formal training a year.
• Participate in conducting fraud awareness training to company associates.
• Network with law enforcement and other investigators within the SIU Industry.
• Adhere to privacy guidelines.
• Cover large geographic areas (Greater NYC, boroughs).
• Complete accurate monthly reports and submit to supervisor timely

Qualifications

Qualifications and Education

• Bachelor's Degree or an Associate's Degree plus a minimum of two years' experience with insurance related employment.
• A minimum of five years of experience within the insurance industry or a minimum of five years of law enforcement experience.
• Valid New York Driver's License
• Strong Computer Skills (Microsoft Excel, Word, Access and Outlook)
• Strong verbal and writing skills
• Working knowledge of Home and Auto Policies
• Bi-lingual in Spanish would be preferred
• Knowledge of big data (link analysis, predictive modeling tools etc... not mandatory but preferred).
• Knowledge of medical terminology and treatment plans

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