Claims SIU Consultant

Job not on LinkedIn

🕒 October 5

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Builders Mutual

WebsiteLinkedInAll Job Openings

201 - 500 employees

💼 Consulting

⚖️ Legal

🛡️ Insurance

Consulting • Legal • Insurance

Builders Mutual is a leading writer of commercial insurance products dedicated exclusively to the construction industry. Based in North Carolina, Builders Mutual provides insurance coverage for both residential and commercial construction as well as trade contractors. The company focuses on helping clients reduce risks, prevent fines, and ensure smooth job execution through safety education and risk management consulting. Through strong partnerships with various industry associations, Builders Mutual has expanded its market reach to the Mid-Atlantic and Southeast regions.

📋 Description

• Serve as the single point of accountability for fraud identification and handling strategy across Workers’ Compensation, General Liability, Commercial Auto, Builders Risk, Inland Marine, and Property lines • Set SIU program direction and priorities with Claims leadership • Communicate program performance, trends, and recommendations to senior leadership • Identify cross-line fraud trends, referral patterns, and emerging investigative needs • Own and manage SIU vendor relationships, including referral quality review, invoice and cost auditing, service-level performance tracking, and vendor evaluation • Design and maintain a quality assurance framework for SIU referrals and investigative outcomes • Establish and maintain referral outcome and savings-tracking methodology for quarterly and annual ROI reporting • Build recurring reports on referral volume, cost per referral, outcome type, line-of-business distribution, and other metrics • Consult with Underwriting on front-end, premium, and new-market fraud indicators • Develop and deliver fraud-recognition training for claims adjusters and underwriting staff • Create and maintain adjuster-facing referral guidance, job aids, and procedures • Ensure state-specific SIU and antifraud-plan reporting obligations, mandatory referral procedures, and annual fraud reporting requirements are met • Maintain current knowledge of SIU/antifraud requirements and support a compliance matrix for the company’s multi-state footprint • Report to the Vice President of Claims

🎯 Requirements

• Bachelor's degree preferred and a minimum of five (5) years of relevant claims, SIU, or fraud-investigation experience, or an equivalent combination of education and experience • Law Enforcement experience is a plus • Demonstrated experience managing or governing a vendor relationship of meaningful scope and cost, including invoice auditing and performance evaluation • Working knowledge of insurance fraud statutes and SIU/antifraud regulatory frameworks, including the NAIC Insurance Fraud Prevention Model Act and related SIU Model Regulation • Demonstrated ability to build tracking methodologies and translate claims data into defensible, decision-ready reporting • Strong verbal and written communication skills • Ability to train adjuster staff and consult effectively with Underwriting • Sound judgment and initiative • Ability to operate independently as an individual contributor • Ability to travel 10–15% for vendor site engagement, industry conferences, and state regulatory matters • Occasional travel for vendor relationships and compliance

🏖️ Benefits

• Competitive compensation and a performance bonus program • 3 weeks of PTO to start, plus your birthday off • A 37.5-hour workweek, with Fridays ending at 2:30 PM • Professional development through Builders University • Everyday Wins recognition with swag and extra time off • 8 paid Volunteer Time Off (VTO) hours to give back • Comprehensive benefits that support your wellbeing today and your future tomorrow • Remote work from a home office • Virtual collaboration with the team • Company events and meetings