SIU Field Investigator - National General

Overview SIU Field Investigator in the Special Investigations Unit (SIU) in Memphis, TN. This is a field-based, location-specific role requiring investigative experience and residence in the Greater Memphis area. Responsibilities Enters SIU claim data information into multiple SIU systems Reviews investigations with fraud outcomes to validate whether denial is appropriate Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement Conducts complex online data application searches, research, and evaluation Conducts complex site inspections, including body shops, medical clinics, loss locations etc. Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages Researches and responds to complex customer communications, concerns, conflicts or issues Supervisory Responsibilities This job does not have supervisory duties. Qualifications Experience investigating complex, multi-discipline coverage and claims for potential fraud Ability to conduct background searches, scene investigations, clinic inspections, take recorded statements, review medical notes and bills, conduct witness interviews and social media searches Experience with surveillance and scene reconstructions; ability to determine if fraud can be substantiated and support litigation Strong analytical, research, and data entry skills; ability to summarize documents and document notes in claim systems Ability to utilize analytic tools or SIU field intelligence for identifying complex claims Excellent communication and customer service skills Residence in Greater Memphis, TN area or willingness to relocate #J-18808-Ljbffr National General