SIU Investigator

Loyalty MGA is looking for a SIU Investigator to identify and investigate potential fraudulent claims. This position offers a hybrid work schedule upon successfully completing the company’s probation period. The SIU Investigator will be responsible for conducting thorough investigations, gathering evidence, and collaborating with internal teams to prevent and detect fraud. The ideal candidate will have a keen eye for detail, strong investigative skills, and experience in claims fraud prevention.

Responsibilities:

Fraud Investigation:

• Investigate suspicious claims for potential fraud, including interviews, surveillance, and evidence collection.
• Analyze claims data to identify patterns and red flags that may indicate fraudulent activity.

Reporting & Documentation:

• Prepare detailed investigation reports, documenting findings and supporting evidence.
• Present investigative findings to management and regulatory bodies as needed.

Collaboration:

• Work closely with claims adjusters, legal teams, and law enforcement to support fraud investigations.
• Assist in developing strategies to prevent fraud and improve claims processes.

Compliance:

• Ensure investigations comply with company policies, industry regulations, and legal requirements.
• Maintain confidentiality of sensitive information related to investigations.

Requirements:

• High School Diploma or G.E.D.
• 6 months of claims handling or investigative experience in any field.
• Experience in Loss Prevention and Surveillance preferred.
• Bilingual in English and Spanish is required.
• Active insurance adjuster’s license preferred; must obtain and maintain as needed.
• Strong customer service and communication skills.
• Basic proficiency in Microsoft Office.

• Negotiate settlements with claimants or their representatives, ensuring fair and equitable agreements.
• Adhere to ethical standards and guidelines while handling claims and interacting with stakeholders.
• High school diploma or equivalent; bachelor's degree in business, or related field preferred.
• Strong problem-solving skills with a focus on delivering timely and effective resolutions to customer issues.
• Strong organizational and time management skills to handle multiple tasks efficiently.
• Professional, energetic, and ability to thrive in a fast-paced environment and adapt to changing priorities.
• Excellent verbal and written communication skills. Ability to articulate solutions clearly and concisely.