Insurance Fraud Investigator SIU - Orlando Florida
Full-time
United Auto Insurance
COMPANY OVERVIEW: Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for Insurance Fraud Investigator (SIU) to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business. Remote position, and must be located in the Orlando, Florida area SCOPE: As a Insurance Fraud Investigator I(SIU) for UAIC, you will be responsible for conducting field as well as desk investigations to detect fraud on high complexity claims involving staged auto accidents, fraud rings, and questionable medical treatment. You will provide investigative expertise to limit exposure and protect company assets. These investigations involve auto liability private passenger and commercial auto lines for non-standard policies. Investigations may include database searches, Examinations Under Oath, and scene canvasses. Focusing on thoroughness, quality, timeliness, and cost control. Our special investigator II will prepare and submit SIU investigative reports covering all phases of the investigation in each case for approval. You will maintain continued contact during investigations with supervision, internal legal professionals, external medical professionals, government/regulatory agencies, NICB, Law Enforcement, and outsourced vendors. The Investigator will also be responsible for effectively carrying out investigations of alleged Fraud, Waste, and Abuse by medical providers, body shops, and others. DUTIES :
- Conduct clinic inspections and examinations under oath.
- Conduct in-depth research and review of suspected fraudulent or abusive patterns to develop sufficient evidence to conclusively establish facts involving insureds, claimants, medical and auto body shop providers, or other entities.
- Collect, utilize, and interpret data from a variety of computer-generated reports and other sources; thereby identifying and documenting questionable patterns related to medical modalities, procedures, and other practices which merit further investigation.
- Maintains assigned investigation files, documents evidence, and prepares comprehensive investigation reports at the completion of each investigation.
- Assist in conducting comprehensive interviews: medical and other providers aforementioned, insureds/claimants in the presence of their attorneys where applicable, and witnesses to obtain statements and information admissible under accepted rules of evidence in civil and criminal court proceedings.
- Conducts special projects initiatives/investigations referred by the House Counsel.
- Establishes and maintains liaison with NICB, Law Enforcement officers, and others to obtain assistance in conducting, facilitating, and enhancing investigations.
- Knowledgeable about all applicable insurance regulations, especially PIP regulations to ensure duties and assignments are carried out within the requirements of applicable law and office expectations.
- Mentor and teach less experienced investigators, promoting teamwork and collaboration among the department. Encourage sharing of insights, experiences, and best practices within the SIU team.
- Associate or bachelor’s degree in a related field preferred and/or 5 years of related work experience.
- Bilingual (English & Spanish)
- Knowledge of current procedural terminology.
- Strong critical thinking and analytical skills with the ability to interpret data and trends.
- In-depth knowledge of applicable fraud statutes, regulations, and industry best practices.
- High degree of integrity as demonstrated by appropriate treatment of confidential information, and adherence to policies, rules, and regulations.
- Effective communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.
- Excellent organizational and project management abilities, with a keen eye for detail.
- Expert knowledge of medical claims processing and investigations, a strong plus.
- Experience in CPT codes and medical terminology is highly preferred.
- Detail-oriented investigator with strong organizational and time management abilities
- Analytical and interview skills: ability to make deductions; logical and sequential thinker.
- Computer literate; database and Internet proficient. Has knowledge of available resources (internal and external) to assist in investigations.
- Ability to work with others in a team environment.
- 401(k) Retirement Savings Plan with employer match.
- Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
- Paid Time Off, Holidays, and Leave programs.
- Flexible spending accounts
- Basic Life Insurance and Voluntary Life/ADD
- Short Term and Long-Term Disability
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Insurance Fraud Investigator SIU - Orlando Florida in Orlando, FL vacancy
- The Florida League of Cities in Orlando, FL is seeking an experienced Workers' Compensation Claims Adjuster to manage complex claims while serving members... ...week, generous leave, comprehensive health and dental insurance, a retirement plan with employer contributions, and...SuggestedWork at officeRemote work
- The State of Florida, Department of Financial Services, Criminal Investigations Division, Bureau of Insurance Fraud, seeks a Law Enforcement Investigator II (Sworn Insurance Fraud Detective) in Orlando. This sworn position requires experience, certification eligibility...SuggestedWork at office
- ...Claims Adjuster – Workers Compensation (Florida) Employer: Gallagher Location: Fully... ...the outcome of the claim file. Investigate, evaluate, and resolve complex workers‑compensation... ...day one. ~ Life and accident insurance. ~401(k) and Roth options. ~ Tax‑advantaged...SuggestedRemote workFlexible hours
Gallagher
Orlando, FL4 days ago - ...alternative application process. Remote, US Remote in North Florida At Frontline Insurance, we are on a mission to Make Things Better, and our... ...- Learn fundamentals of property damage estimation. Investigation & Evidence - Acquire techniques for gathering and evaluating...SuggestedTemporary workTraineeshipWork at officeLocal areaRemote work
- ...INSURANCE ADJUSTER CAREER OPPORTUNITIES Licensed Adjusters & Career-Entry Applicants Welcome No prior insurance adjusting experience is required for career-entry applicants. Are you interested in building a career as an Independent Insurance Claims Adjuster?...SuggestedFull timeFlexible hours
$22 - $24 per hour
...Employment Type: Permanent - Full Time Location: Orlando, FL Reporting To: Trip Lawrence... ...operations, and spearhead transformation in the insurance and regulated sectors. We are looking... ...at the client’s main office in Orlando, Florida. Key Responsibilities Intake, collect,...Permanent employmentFull timeTemporary workFor contractorsTraineeshipLocal areaDavies Public Affairs
Orlando, FL3 days ago$22 - $24 per hour
...Claims Administration & Adjusting Location: Orlando, FL Compensation: $22.00 - $24.00 / hour... ...at the client’s main office in Orlando, Florida. Key Responsibilities Intake, collect,... ...claims that fall under the client’s insurance policies. Ensure documents or other materials...Temporary workTraineeshipLocal areaDavies North America
Orlando, FL3 days ago- ...Florida League of Cities | Orlando, FL Join a Mission-Driven Organization with Outstanding Benefits and... ...Medical Leave Comprehensive Health Insurance with employer contributions toward... ...Workers' Compensation Claims Adjuster investigates, evaluates, negotiates, and resolves...Work at officeRemote workMonday to FridayFlexible hours
Wells Media Group
Orlando, FL3 days ago - Florida League of Cities in Orlando seeks an insurance claims adjuster to investigate auto, non-complex general liability, and first-party property claims for a member-based organization. You will verify coverage, determine liability, evaluate damages, and negotiate settlements...Work at office
$45.32k
...process. FIELD APPRAISER II, RESIDENTIAL VALUATIONS Full Time Orlando, FL, US 25 days ago Requisition ID: 1213 SALARY:... ...will also perform periodic inspections in compliance with Florida Statutes. Investigates and responds to inquiries from property owners or their legal...Full timeWork at officeWeekend work- ...is seeking a Field Appraiser II for Residential Valuations in Orlando, FL. The role emphasizes gathering and verifying data on residential... ...3 years in real estate appraisal, an associate degree, and a Florida driver's license. Spanish bilingualism is preferred. The...Full time
- Gallagher Bassett is hiring for a remote Claims Adjuster in Orlando, Florida. The role requires a minimum of 3 years of experience managing workers compensation claims, including lost time and litigation. The ideal candidate will possess strong analytical skills, exceptional...Remote jobFlexible hours
- Florida League of Cities in Orlando, FL is seeking an experienced Workers’ Compensation Claims Adjuster to join our team. This role focuses on managing... ...coverage and compensability, conduct thorough investigations, negotiate settlements, and maintain accurate claim documentation...
- Florida League of Cities in Orlando seeks a Workers’ Compensation Claims Adjuster for Lost Time to investigate, evaluate, and negotiate on lost-time claims, ensuring proper coverage and... ...and skill in negotiations. Degree in Insurance/Business or 3-5 years experience plus...
$33.5 - $38.5 per hour
...Join ReSource Pro! Your Role ReSource Pro is seeking a Premium Insurance Field Auditor (1099/Contractor) to play a vital role in... ...successful Candidates must reside in or in the immediate area of Orlando or Lakeland, FL. Personal phone and laptop or computer. The ability...Hourly payContract workFor contractorsWork experience placementLive outLocal areaImmediate startRemote work$33.5 - $38.5 per hour
A leading insurance services provider is seeking a Premium Insurance Field Auditor based in or near Orlando, FL. This contract role involves traveling to on-site audits, analyzing financial records, and preparing audit reports. Candidates should demonstrate detail-oriented...Hourly payContract workFor contractorsFlexible hours$33.5 - $38.5 per hour
ReSource Pro Growth Solutions is seeking a Premium Insurance Field Auditor in Orlando, FL. This contractor role involves collecting data from insured businesses, conducting remote audits, and preparing comprehensive reports. Candidates should possess strong communication...For contractorsRemote work- ...Claims Representative I Investigates, determines liability, confirm... ...property. Reports theft, fraud, and arson losses as required... ...College/University in business or insurance preferred or equivalent... ...a must. Must have an active Florida Adjusters License. All qualified...For contractorsWork at office
Florida League of Cities
Orlando, FL3 days ago - ...Compensation Claims Adjuster for Lost Time investigates, evaluates, negotiates, and concludes... ...DutiesDetermines the extent of coverage of insured individuals.Confirm coverage with... ...relevant laws and regulations.Knowledge of Florida Worker's Compensation law.Skill in investigating...Work at office
Florida League of Cities
Orlando, FL2 days ago - Jobtailor is seeking a Commercial Property Loss Adjuster in the Orlando, FL area to handle claims from inspection to final reporting. The role requires experience with loss assessment, evidence gathering, and collaboration with experts, attorneys, and carriers. The candidate...
- IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth...
- Frontline Insurance is seeking a Claims Adjuster Trainee for the North FL Territory. You... ...experience in claims lifecycle, estimating, investigation, subrogation, and coverage evaluation,... ...60-90 days and work in a remote North Florida context. #J-18808-Ljbffr Frontline...Remote jobTraineeship
- ...resorts in top destinations like Orlando, Las Vegas, Gatlinburg, Park... ...Are you a seasoned insurance adjuster with experience in... ...outcomes. If you excel in investigation, litigation management, negotiation... ...is a must have? Valid Florida 6-20 Adjuster’s License Minimum...Daily paidFull timeLocal areaFlexible hours
Westgate Resorts
Ocoee, FL27 days ago - ...multi-task with a high degree of accuracy to be a part of an exciting new company. Responsibilities Scheduling appointments with insureds Adhering to customer requirements and quality standards Examining commercial businesses’ payroll and tax records Prepare...Full timeContract workPart timeShift work
- ...Investigates insurance claims in various settings including retail establishments, public office buildings, corporate facilities, and more. Assesses... ...Loss Assessment Property Inspection Report Preparation Fraud Prevention Research Skills Soft Skills Exceptional Communication...Work at office
Jobtailor
Orlando, FL3 days ago - ...At Morgan & Morgan, the work we do matters. For millions of Americans, we’re their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 states, to client support staff, creative marketing to operations teams,...Full timeLocal area
Morganmorganjobsapplynow
Orlando, FL4 days ago - ...automotive repair processes. You'll evaluate warranty claims, investigate their validity, and ensure all claims are processed efficiently... ...healthcare options, including medical, vision, and dental insurance ~401(k) savings and retirement plans ~ Life insurance coverage...
Integro Insurance Brokers
Orlando, FL4 days ago $15k
...Place to Work® Fortune Best Workplaces in Financial Services & Insurance Property Desk Adjuster PRIMARY PURPOSE : Handles... ...to determine insurance coverage. Conducts thorough investigations, gathers official reports as needed, consults police and hospital...Part timeWork at officeLocal areaSedgwick
Orlando, FL1 day ago- ...At Frontline Insurance, we are on a mission to Make Things Better, and our Desk Adjuster... ...(s) informed on all steps of the claim investigation and progress to resolution. Determine... ...flow of information. Maintain Florida 520 License. Obtain Alabama, North Carolina...Temporary workFor contractorsLocal areaRemote work
Frontline Insurance Managers, Inc.
Lake Mary, FL3 days ago - A leading insurance adjusting firm in Longwood, Florida is seeking Independent Insurance Claims Adjusters to join their dynamic team. This role offers the flexibility to assist individuals and businesses in recovering from unforeseen disasters while enjoying competitive...Flexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Insurance Fraud Investigator SIU - Orlando Florida. Be the first to apply!
Related searches
- financial fraud Orlando, FL
- fraud manager Orlando, FL
- fraud prevention Orlando, FL
- insurance inspection Orlando, FL
- licensed insurance Orlando, FL
- insurance authorization Orlando, FL
- customer service representative insurance Orlando, FL
- insurance defense paralegal Orlando, FL
- insurance sales Orlando, FL
- insurance customer service Orlando, FL