SIU Investigation Adjuster Consultant II - Remote

Overview

This job is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud.

In Short

• Investigate and analyze claims referred to SIU for potential fraud.
• Conduct background searches, scene investigations, and clinic inspections.
• Take recorded statements and review medical notes and bills.
• Conduct witness interviews and social media searches.
• Perform surveillance and create scene reconstructions.
• Provide guidance and mentoring to less senior employees.
• Enter SIU claim data into multiple systems.
• Research and respond to complex customer communications.
• Validate information obtained through investigations.
• Summarize documents and enter notes into claim systems.

Requirements

• 3+ years of previous SIU experience required.
• Experience reviewing medical information or handling provider investigations.
• Texas Adjuster License preferred.
• Ability to work remotely with a dedicated workspace.
• Minimum internet bandwidth of 50 MB down/5 MB up.

Benefits

• Technology bundle including all necessary equipment.
• Connectivity reimbursement of $80 per month.
• Opportunity to work from home permanently.
• Support from a team dedicated to innovative thinking.
• Potential for career growth and development.