SIU Field Investigator - Fraud & Claims Analysis

National General Insurance; Sacramento (CA); On-site; USD 60,000 - 93,000; Full time

Job summary

National General, a member of The Allstate Corporation, seeks an SIU Field Investigator to uncover fraud in insurance claims across Northern California. The role emphasizes field investigations, data analysis, and collaboration with claim teams to protect customers and the business from fraud.

The candidate should bring a strong background in investigations and insurance, with the ability to conduct site inspections and complex data research across the San Francisco, Oakland, San Jose,

Qualifications

• Strong background in investigations and insurance.
• Experience conducting field investigations and fraud-related inquiries.
• Ability to analyze complex claim information and identify fraud indicators.

Responsibilities

• Enter SIU claim data into multiple SIU systems.
• Review investigations with fraud outcomes to validate denial appropriateness.
• Update files with investigation outcomes and route to market claim offices as needed.
• Conduct complex online data searches, research, and evaluation.
• Perform site inspections of loss locations, body shops, and medical clinics.
• Investigate complex cases potentially involving fraud and determine if payment is warranted.
• Validate information gathered and follow up on leads.
• Summarize documents and enter notes in claim systems with evaluations and decisions.
• Use SIU tools to identify complex claims for investigation and support fraud evidence.
• Respond to complex customer communications and resolve issues.

Skills

Analytical Thinking

Critical Thinking

Decision Making

Documentations

Evidence Gathering

Fraud Investigations

Insurance Claims Investigations

Interviewing

Investigative Skills

Problem Analysis

Special Investigations

Time Management

Tools

SIU Systems

Claim Management Software

Job description

National General, a member of The Allstate Corporation, seeks an SIU Field Investigator to uncover fraud in insurance claims across Northern California. The role emphasizes field investigations, data analysis, and collaboration with claim teams to protect customers and the business from fraud.

The candidate should bring a strong background in investigations and insurance, with the ability to conduct site inspections and complex data research across the San Francisco, Oakland, San Jose,