The SIU Desk Investigator I is responsible for the investigation of simple claims that may contain elements of fraud or claims otherwise deemed suspicious in nature. These investigations may include single exposure losses and non-represented PIP/Med Pay claims. A Special Desk Investigator I may also handle task-based items including but not limited to EDR pulls, vehicle inspections at drive in locations, skip traces, and initial background investigation. Uses appropriate field, computer, and telephone investigative techniques. Documents all investigative actions in a thorough, timely, and appropriate manner. Attends necessary training schools and participates in training to develop and improve skills, develops contacts, and meets state regulatory educational requirements. Prepares necessary reports for state fraud bureaus and cooperates with state agencies as required by law and management. Responsible for communicating critical situations to the Special Investigation Unit and field managers. Develops and maintains contacts with other Special Investigative Units and fraud related organizations. Routinely practices independent judgement and discretion. Must conform to the Unfair Claim Practices Act and Fraud Statutes of the state in which the claim is handled. Performs all other duties as assigned. Position Qualifications: A minimum of two years claims handling experience and demonstrated ability to recognize and handle suspicious claims activity. Excellent written and verbal communication skills, thorough working knowledge of computers, ability to type proficiently, and operate efficiently in a modern “paperless” environment are essential. Bilingual in Spanish Preferred. Demonstrates effective and diplomatic oral and written communication skills. Proficiency in using Microsoft products such as Outlook, Word, PowerPoint, and Excel. Sponsorship is not accepted for this opportunity.
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