SIU Consultant – Triage

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🕒 Yesterday

🌽 Illinois, New Jersey, +2 more states – Remote

🌽 Illinois – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🤠 Texas – Remote

💵 $77.1k - $147.4k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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USAA

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1922

🏦 Banking

💸 Finance

Banking • Insurance • Finance

USAA is a financial services company that provides banking, insurance, and investment products to current and former military members and their families. The company is committed to superior customer service and secure technology for its members, offering a private portal for business access and interaction with their services.

📋 Description

• Perform triage duties to review claims identified by our predicative fraud tool to determine if an SIU investigation is warranted • Protect USAA and 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 • Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims • Participates in the development of fraud prevention strategies • Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools • Make recommendations within defined authority guidelines • Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome • Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention • May serve as a resource team member on specific matters through demonstrated skill or training • Assists with the delivery of fraud awareness training initiatives in a defined environment

🎯 Requirements

• High School Diploma or General Equivalency Diploma (GED) • 2+ years experience as an SIU Investigator investigating claims from multiple lines of business (auto/property) • Fraud industry investigation experience • Experience obtaining statements from various parties to incidents, witnesses, and suspects • Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud • Demonstrated 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

🏖️ Benefits

• Comprehensive medical, dental and vision plans • 401(k) • Pension • Life insurance • Parental benefits • Adoption assistance • Paid time off program with paid holidays plus 16 paid volunteer hours • Various wellness programs • Career path planning and continuing education