CITON Claims Solutions, LLC is a premier provider of claim management and administration services for insurance companies, specializing in efficient and innovative solutions tailored to meet each client's unique needs. With a dedicated team of experts and cutting-edge technology, CITON Claims Solutions, LLC ensures seamless processes, accurate assessments, and prompt resolutions, delivering unparalleled value and peace of mind to our clients.

CITON is located on the beautiful space coast of Melbourne, one of the best places to live in Florida. Melbourne offers affordable housing, transportation, and other amenities. Major cities such as Orlando, Tampa, and Miami are all within one to three hours of driving distance.

CITON Claims Solutions LLC is a subsidiary of Orion180 Group Inc., and handles Claims Administration, Management, and Investigation.

Job Summary

The Special Investigation Unit (SIU) Analyst facilitates the identification, investigation, organization, and reporting of suspected insurance fraud. The SIU Analyst will assist the SIU Manager and staff with the daily SIU operations, including tracking of investigations, vendor management, subrogation investigations, requests for information and program development, and other related duties.

Role and Responsibilities

To perform the job successfully, the individual must be able to perform each essential duty satisfactorily and should demonstrate the following competencies to consistently perform the essential functions of this position. All employees are expected to adhere to and be knowledgeable of Orion180 operations standards, established security/safety rules and requirements for attendance. The requirements listed below are representative of the fundamental knowledge, skill, and/or ability required to perform the job successfully:

• Facilitate the investigation of suspected insurance fraud by documenting and forwarding information received to the SIU Manager.
• Develop investigative leads through use of appropriate database queries and other methods.
• Review all SIU referrals and update tracking information.
• Coordinate all Examinations Under Oath conducted by the Special Investigation Unit.
• Manage all immunity and claims file requests.
• Assist in the operational processes for SIU vendors and vendor management.
• Assist in subrogation investigations.
• Assist with state fraud plans and other reporting requirements.
• Act as the department liaison, answer questions, and direct others to appropriate points of contact.
• Provide support to the SIU team and other departments as needed.
• Properly document all correspondence, reports, discussions, and decisions.
• Assist in the training of new personnel. Create workflows, training manuals etc.
• Facilitate all SIU monthly and yearly reporting.
• Perform any other task, project, or responsibility assigned by the SIU manager.

Qualifications and Education Requirements

• Bachelor’s degree or equivalent combination of skills and experience
• Experience in special investigations, compliance, law enforcement, or insurance-related field.
• Knowledge of audits, data analytics, reporting, and data modeling
• Ability to conduct research of public records and proprietary databases for information impacting a claim or policy.
• Proficient in Microsoft Office (Word, Excel, Outlook, etc.)
• Demonstrated knowledge of interpreting policies and reviewing claims.
• Excellent written and verbal communication skills
• Strong interpersonal and organizational skills
• High degree of accuracy, attention to detail, and sense of urgency in a fast-paced, high-performance environment.
• High level of organization and time management skills.
• Ability to work independently.

Physical Demands

While performing general office duties for this position, the employee is regularly required to sit, stand and/or walk around (including the use of stairs). Other demands include the ability to openly communicate with others by talking, listening, and reading, able to lift light objects (<25lbs), and use standard office equipment such as computer, printer, and phone. In addition, there is an occasional need to bend, twist or stoop to open/close cabinets, reach for files or other standard office type objects.

Work Environment

The office environment is generally quiet and, in a temperature, controlled setting with random adjustments in noise or temperature due conversations, unscheduled maintenance repairs to the building or its interior offices or unpredictable situations due to weather or other acts beyond company control. An employee must be willing to work their regularly assigned work schedule for their duties and/or job responsibilities and in times of need, be able to work an extended schedule depending on company/department needs, project requirements or customer demands.

If you are interested in applying for employment and need special assistance or an accommodation to apply for a posted position, contact our Human Resources department at (321) 460-8484 or HR@orion180.com

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and will not be discriminated against based on disability.