What are the responsibilities and job description for the SIU Claims Coordinator position at Coaction Global?
At Coaction, we’re a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.
Position Summary
The SIU Claims Specialist is responsible for leading the company’s Special Investigations Unit, working with the Coaction approved investigation panel, overseeing the detection, investigation, and prevention of fraudulent insurance claims across all lines of business. This role ensures compliance with state and regulatory reporting requirements, drives investigative best practices, and partners closely with claims leadership, underwriting, and legal teams to mitigate fraud risk and protect company assets.
Key Responsibilities
Equal Opportunity Employer
Coaction is an Equal Employment Opportunity employer. Coaction’s policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected, you will receive an email directly from the Coaction Recruiting Team at coaction@myworkday.com asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
Position Summary
The SIU Claims Specialist is responsible for leading the company’s Special Investigations Unit, working with the Coaction approved investigation panel, overseeing the detection, investigation, and prevention of fraudulent insurance claims across all lines of business. This role ensures compliance with state and regulatory reporting requirements, drives investigative best practices, and partners closely with claims leadership, underwriting, and legal teams to mitigate fraud risk and protect company assets.
Key Responsibilities
- Manage workflow, case assignments, and performance metrics to ensure timely and effective investigations.
- Establish and maintain investigative standards, protocols, and quality controls.
- Oversee the identification of suspicious claims through analytics, adjuster referrals, and external intelligence.
- Direct and support complex or high-exposure investigations.
- Where appropriate coordinate field investigations, interviews, scene inspections, surveillance, background and social media investigations and evidence collection.
- Ensure proper documentation and investigative reporting to support claim decisions and potential litigation.
- Maintain full compliance with all state SIU regulations, reporting requirements, and fraud registry submissions.
- Serve as the primary contact for state fraud departments, law enforcement, and regulatory agencies.
- Assist in preparing and submitting mandated annual SIU plans, training documentation, and statistical reports.
- Partner with Claims leadership to identify fraud trends and provide recommendations for process improvements.
- Work with Underwriting to communicate emerging fraud patterns, risk indicators, and underwriting controls.
- Support the Legal department in cases progressing to litigation or criminal prosecution.
- Coordinate and/or deliver fraud awareness training to adjusters, examiners, and other business units.
- Utilize data analytics tools to identify fraudulent patterns, emerging schemes, and abuse trends.
- Develop dashboards, reports, and KPIs to measure unit effectiveness and program impact.
- Present fraud insights and trends to executive leadership.
- Manage relationships with external investigative vendors, surveillance firms, forensic experts, and law enforcement.
- Evaluate vendor performance and ensure cost-effective use of external resources.
- Bachelor’s degree in criminal justice, Business, Risk Management, or related field preferred.
- 3 years of insurance claims or investigative experience
- Prior Law Enforcement, SIU or Insurance Fraud experience strongly preferred.
- Professional certifications such as CIFI, CFI, CFE, FCLS, or PCI is highly desirable.
- This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.**
Equal Opportunity Employer
Coaction is an Equal Employment Opportunity employer. Coaction’s policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected, you will receive an email directly from the Coaction Recruiting Team at coaction@myworkday.com asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
Salary : $60,000 - $90,000