SIU Field Investigator (Los Angeles area)

$59,904 - $99,694/Yr

Merastar Insurance Company - Cerritos, CA

Full-time - Mid Level

Remote - Cerritos, CA

5,001-10,000 employees

Insurance Carriers and Related Activities

About the position

The SIU Investigator will conduct field and desk investigations of insurance claims referred to the Special Investigative Unit. This remote role requires the investigator to work from their residence while servicing the Los Angeles area, focusing on the investigation of claims, analysis of facts and evidence, and conducting Examinations Under Oath. The investigator will coordinate with various agencies and maintain documentation of all investigative actions.

Responsibilities

• Conduct field and desk investigations of insurance claims referred to the Special Investigative Unit.
• Analyze and develop facts and evidence related to investigations.
• Conduct and/or direct Examinations Under Oath.
• Coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and law enforcement agencies.
• Attend necessary training schools and participate in training to develop skills and meet state regulatory educational requirements.
• Maintain a diary system on all assigned files to ensure timely recommendations.
• Prepare necessary reports for state fraud bureaus and cooperate with state agencies as required by law and management.
• Keep the Special Investigation Unit and field managers informed of all critical situations.
• Report findings of investigations and make recommendations to facilitate prompt decisions.
• Develop and maintain contacts with other special investigative units and fraud-related organizations.
• Stay updated on changes in law to ensure operations are within legal parameters.

Requirements

• Three years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or five years of professional investigation experience involving economic or insurance-related matters; or an authorized medical professional to evaluate medical-related claims.
• College Degree or equivalent work experience.
• Working knowledge of digital photo and document metadata and experience using the internet and social networking for investigative purposes.
• Knowledge of the principles of casualty insurance and the auto casualty claims adjustment process.
• Investigative and legal expertise.
• Completion of the NICB Basic and/or Advanced Academies and the Reid Interviewing and Interrogation Courses is desirable.
• Excellent communication skills and thorough working knowledge of Microsoft Office applications.
• Thorough knowledge of the workings of related state and federal agencies.
• Oral and written communication skills to promote a favorable company image.

Nice-to-haves

• Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations.
• Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations.

Benefits

• Health and dental plans within the first month of employment.
• Robust 401(k) match and various retirement plans.
• Tuition Assistance Program and paid certifications.
• Volunteer programs and community contribution opportunities.
• Generous paid time off and business casual dress.
• Employee discounts for shopping, dining, and travel through Kemper Perks.