SIU Investigator

The primary function of the SIU Investigator is to investigate, aid and control the efforts of the Acceptance SIU in its anti-fraud program.

Essential Job Functions 

Key Function: Investigation 

• Investigates, aids, and controls the efforts of the Acceptance SIU in its anti-fraud program
• Conducts thorough analysis of a claim file, application, or insurance transaction, that includes consideration of factors indicating insurance fraud
• Identifies and interviews potential witnesses who may provide information on the accuracy of the claim or application
• Utilizes one or more industry recognized databases identified by the SIU as appropriate for use in fraud investigations involving the specific line of insurance in question
• Preserves documentation and/or other evidence obtained during an investigation
• Writes concise and complete summary of the entire investigation meeting the required criteria
• Coordinates and conducts EUO examinations as warranted to aid in the final outcome of a claim investigation
• Investigates each credible referral of suspected insurance fraud that it receives from the integral anti-fraud personnel, including automated or system generated referrals
• Ensures effective implementation of fraud detection and/or deterrent protocols
• Reports all suspected fraudulent insurance transactions to the appropriate parties within the required timeframes
• Participates in the support, and service resources, to meet account performance objectives and company’s expectations
• Consistently utilizes the SIU tools and benchmarks set by management
• Continually evaluates and looks for ways to enhance possibilities towards fighting insurance fraud

Key Function: Interpersonal Skills

• Works with all members of the Claims Management, Underwriting and Marketing Teams, Claim Support Staff, Independent Vendors, Defense Counsel, and all other entities as may be required
• Testifies in civil and criminal actions related to investigations when required
• Assists with the training of Acceptance anti-fraud personnel including outside vendors as required, in fraud detection, prevention, and suspect claim handling measures
• Represents the Company at various industry, state and local organizations which focus on anti-fraud activities
• Coordinates investigation of complex suspect claims and assignments as warranted ensuring proper resolution
• Collaborates with the SIU Managers on all matters of the SIU function
• Establishes and maintains relationships with law enforcement, Department of Insurance officials and insurance industry personnel and assist them when required
•  Other duties as assigned

Desired Qualifications 

• Requires a Bachelor’s degree or equivalent experience   
• Requires minimum of 5 years relevant experience.
• Prior law enforcement preferred
• Experience handling Florida Personal Injury Protection (PIP) claim investigations is a plus (applies to FL positions only) 
• Preferred designation as an insurance professional (including but not limited to AIC, CPCU, SCLA)  

• Proven management of SIU investigations, fraud investigations 
• Knowledge and understanding of SIU compliance 
• Proficient in Microsoft Suite (i.e. Word, Excel, PowerPoint, etc.)  
• Proficient in interdepartmental knowledge, relations, and navigation  

• Excellent interpersonal and communication skills, including presentation skills  
• Strong organizational, time management, and/or prioritization abilities  
• Ability to work under tight deadlines with flexibility  
• Strong analytical and technical skills; superior business acumen   
• Excellent problem solving, critical thinking, and decision-making skills  

• Commitment to Acceptance’s company values  
• Able to lift 0-10 pounds without assistance  

#LI-REMOTE

As a Team Member at First Acceptance Insurance Company, you will be part of a growing organization that continues to evolve and positively impacts the lives of our team members and customers.

We are looking for team members that engage – who take responsibility for themselves and take care of their customers and colleagues. Ideal candidates can compose themselves under pressure, have a “make It right” mindset, and focus their energies on solving problems. This means you’ll be supported by a team with all these qualities, too. If this sounds like the kind of team you’d like to join, we want to hear from you! ​

First Acceptance Insurance Company offers a full line of benefits including: Health Insurance, Dental, Vision, Paid Vacation, Disability Insurance and Employer Matching 401(k) Program.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants are considered for position and are evaluated without regard to mental or physical disability, race, religion, sexual orientation, color, gender, national origin, age, marital status, military or veteran status or any other protected local, state or federal status unrelated to the performance of the work involved.