SIU Senior Investigator

Summary

At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts - always supporting each other to do our best work. Join us, and let's improve lives together. This position is eligible to work from home anywhere in the United StatesEssential Functions: Promptly investigates and evaluates SIU referrals of moderate to high complexity, including organized ring activityReviews claim, underwriting and premium audit files pertinent to the referralInitiates contact with other departments, insureds, claimants, witnesses, vendors, other carriers, attorneys, law enforcement or any others to obtain informationResearches background information, including public records, claims history and social media sitesTakes statements from insureds, claimants, witnesses and other pertinent parties.Documents all special investigative handling and activityReviews the facts of an investigation and completes field investigationsAttends examinations under oath (EUOs) and depositions for assigned casesSecures and reviews bills, invoices, receipts and other documentation for legitimacy and accuracyTracks trends and patterns of investigations regarding organized ring activityProvides status updates on special investigations to branch or corporate office team members, agents, defense counsel and law enforcement entitiesIdentifies, investigates and pursues opportunities for recovery or restitutionDevelops and evaluates investigative data and evidence to formulate recommendationsConducts analysis of all investigative materials to formulate a recommendation for further handling, including payment, compromise or denial of a claim or rescission of a policyPrepares a special report with written summaries of all investigative dataCommunicates with branch and corporate office departments, as well as other impacted entities, regarding investigative activities and evidence to support or exonerate potential fraudPrepares documentation in compliance with a state's anti-fraud reporting requirements on each investigationPrepares evidence packets related to civil litigation or criminal prosecution for submission to defense counsel, National Insurance Crime Bureau (NICB), State Fraud Bureaus and/or Attorney General's offices or other law enforcement entitiesDevelops assigned internal and external anti-fraud training and marketing of SIU servicesDevelops assigned internal and external anti-fraud trainingProvides anti-fraud training to internal and external customers through investigative discussions and dissemination of educational materialsCollaborates with team members in developing marketing strategies for the SIU department and its servicesImplements assigned marketing strategiesParticipates in the establishment of effective policy standards, practices, techniques and procedures for the investigation, evaluation and disposition of the SIU referral.Maintains active involvement in professional associations within the industry.Education & Experience: Bachelor's degree in business, insurance, criminal justice or related field or equivalent relevant experienceFive years of claims adjusting, investigation or insurance experience or related experiencePrior property and casualty experience preferredFraud Claim Law Specialist (FCLS) designation within the first year of hireInsurance designations, such as INS or AIC, preferredKnowledge, Skills & Abilities: Strong knowledge of the investigative process, including proper identification and collection of physical evidenceStrong knowledge of civil and criminal investigative procedures and the legal systemStrong knowledge of various statement taking techniques, collection and analysis of public and private recordsGood knowledge of property and casualty insurance industry and fraud awareness preferredStrong investigative skills and ability to make sound decisionsGood conflict resolution, negotiation and facilitation abilitiesAbility to work independently and as part of a teamStrong verbal and written communication skills, including file documentation and report writingGood knowledge of computers and Microsoft Office SuiteAttendance of the National Insurance Crime Bureau SIU Academy within the first two years of hireOccasional travel; a valid driver's license with an acceptable motor vehicle report per company standards required if drivingPer the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $75,910.79 - $97,485.70. The hiring range for other locations may vary. The hiring salary range for this position will vary based on geographic location, falling within either of the following: $78,726 - $108,771 or $87,008 - $119,646 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.All of our locations are tobacco free including in company vehicles.Why should you choose to apply for a position at EMC? More than 105 years of financial strength and stabilityNamed a five-star insurance carrier by Insurance Business AmericaTwo-time recipient of the Best Practices Award of Excellence from the Independent Agents & Brokers of AmericaMultiple locations recognized as Top Workplaces based solely on team member feedbackCorporate culture that engages and empowers team members to achieve their bestOutstanding benefits with life, medical, dental, vision and prescription drug coverageCompetitive paid time off plan and a full day of volunteer time off annuallyFinancial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awardsProfessional development and growth opportunities, including tuition reimbursementWellness initiatives to improve team member well-being and reduce health insurance costsFlexibility to dress for your day and opportunities for alternative work arrangementsEMC complies with labor law requirements.View the federal and e-verify labor law posters.Notice at Collection Privacy Policy (EMCC) - California Consumer Privacy Notice (EMCNL) - California Consumer Privacy NoticeFor information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.#J-18808-Ljbffr

Job Description

At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts - always supporting each other to do our best work. Join us, and let's improve lives together. This position is eligible to work from home anywhere in the United StatesEssential Functions: Promptly investigates and evaluates SIU referrals of moderate to high complexity, including organized ring activityReviews claim, underwriting and premium audit files pertinent to the referralInitiates contact with other departments, insureds, claimants, witnesses, vendors, other carriers, attorneys, law enforcement or any others to obtain informationResearches background information, including public records, claims history and social media sitesTakes statements from insureds, claimants, witnesses and other pertinent parties.Documents all special investigative handling and activityReviews the facts of an investigation and completes field investigationsAttends examinations under oath (EUOs) and depositions for assigned casesSecures and reviews bills, invoices, receipts and other documentation for legitimacy and accuracyTracks trends and patterns of investigations regarding organized ring activityProvides status updates on special investigations to branch or corporate office team members, agents, defense counsel and law enforcement entitiesIdentifies, investigates and pursues opportunities for recovery or restitutionDevelops and evaluates investigative data and evidence to formulate recommendationsConducts analysis of all investigative materials to formulate a recommendation for further handling, including payment, compromise or denial of a claim or rescission of a policyPrepares a special report with written summaries of all investigative dataCommunicates with branch and corporate office departments, as well as other impacted entities, regarding investigative activities and evidence to support or exonerate potential fraudPrepares documentation in compliance with a state's anti-fraud reporting requirements on each investigationPrepares evidence packets related to civil litigation or criminal prosecution for submission to defense counsel, National Insurance Crime Bureau (NICB), State Fraud Bureaus and/or Attorney General's offices or other law enforcement entitiesDevelops assigned internal and external anti-fraud training and marketing of SIU servicesDevelops assigned internal and external anti-fraud trainingProvides anti-fraud training to internal and external customers through investigative discussions and dissemination of educational materialsCollaborates with team members in developing marketing strategies for the SIU department and its servicesImplements assigned marketing strategiesParticipates in the establishment of effective policy standards, practices, techniques and procedures for the investigation, evaluation and disposition of the SIU referral.Maintains active involvement in professional associations within the industry.Education & Experience: Bachelor's degree in business, insurance, criminal justice or related field or equivalent relevant experienceFive years of claims adjusting, investigation or insurance experience or related experiencePrior property and casualty experience preferredFraud Claim Law Specialist (FCLS) designation within the first year of hireInsurance designations, such as INS or AIC, preferredKnowledge, Skills & Abilities: Strong knowledge of the investigative process, including proper identification and collection of physical evidenceStrong knowledge of civil and criminal investigative procedures and the legal systemStrong knowledge of various statement taking techniques, collection and analysis of public and private recordsGood knowledge of property and casualty insurance industry and fraud awareness preferredStrong investigative skills and ability to make sound decisionsGood conflict resolution, negotiation and facilitation abilitiesAbility to work independently and as part of a teamStrong verbal and written communication skills, including file documentation and report writingGood knowledge of computers and Microsoft Office SuiteAttendance of the National Insurance Crime Bureau SIU Academy within the first two years of hireOccasional travel; a valid driver's license with an acceptable motor vehicle report per company standards required if drivingPer the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $75,910.79 - $97,485.70. The hiring range for other locations may vary. The hiring salary range for this position will vary based on geographic location, falling within either of the following: $78,726 - $108,771 or $87,008 - $119,646 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.All of our locations are tobacco free including in company vehicles.Why should you choose to apply for a position at EMC? More than 105 years of financial strength and stabilityNamed a five-star insurance carrier by Insurance Business AmericaTwo-time recipient of the Best Practices Award of Excellence from the Independent Agents & Brokers of AmericaMultiple locations recognized as Top Workplaces based solely on team member feedbackCorporate culture that engages and empowers team members to achieve their bestOutstanding benefits with life, medical, dental, vision and prescription drug coverageCompetitive paid time off plan and a full day of volunteer time off annuallyFinancial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awardsProfessional development and growth opportunities, including tuition reimbursementWellness initiatives to improve team member well-being and reduce health insurance costsFlexibility to dress for your day and opportunities for alternative work arrangementsEMC complies with labor law requirements.View the federal and e-verify labor law posters.Notice at Collection Privacy Policy (EMCC) - California Consumer Privacy Notice (EMCNL) - California Consumer Privacy NoticeFor information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.#J-18808-Ljbffr