Special Investigations Unit (SIU) Investigator/Case manager

Allied Universal; Raleigh (NC); Remote; USD 50,000 - 80,000; Full time

Job summary

Join a forward-thinking company as a Special Investigations Unit Investigator/Case Manager, where you will play a crucial role in insurance claim investigations. This position allows you to work from home anywhere in the United States, providing flexibility while you contribute to a team committed to excellence and innovation. You will investigate claims, develop action plans, and ensure compliance with regulatory standards. Enjoy a comprehensive benefits package, including medical, dental, and retirement plans, as you grow your career in a dynamic environment that values your contributions and supports your professional development.

Benefits

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Paid holidays

Sick days

Vacation time

Qualifications

• Bachelor's degree and 2 years of insurance experience preferred.
• Proficiency in Microsoft Office and investigative resources required.

Responsibilities

• Investigate insurance claims and obtain statements via phone.
• Communicate compliance requirements to clients and staff.

Skills

Insurance terminology

Excel proficiency

Attention to detail

Communication skills

Internet-based investigative resources

Education

Bachelor's degree

Tools

Microsoft Office

Accurint

TLO

Job description

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you’re ready to grow with the best, explore a career with us and make a difference. Enjoy comprehensive benefits for most full-time positions, including medical, dental, and vision coverage, life insurance, retirement plans, employee assistance programs, and exclusive perks.

Allied Universal is hiring a Special Investigations Unit (SIU) Investigator/Case Manager!

***Work from home anywhere in the United States***

RESPONSIBILITIES:

• Investigate insurance claims and obtain statements via phone.
• Use independent judgment and client consultation to define and execute investigative action plans on all SIU Referrals.
• Close files in a timely manner
• Daily communication with clients to effectively obtain required information for completion of state fraud referrals; case findings; & audits.
• Communicates compliance requirements to clients and field staff in order to ensure orderly and timely processing of referrals.
• Coordinates resources to log the details of an active state fraud referral.
• Assist in compiling all data required for SIU compliance audits with Departments of Insurance as well as with SIU clients.
• Assist in the administration and management of various DOI portal access.
• Liaison with NICB and State DOI contacts - Communicates regularly with the various Departments of Insurance or Law Enforcement Agencies in all states to ensure compliance requirements are maintained.
• Assists in the identification of red flag indicators, development of action plans on individual files, writing a clear and concise summary, and accurate submissions of State Fraud Referrals (SFR) to the various Departments of Insurance or Law Enforcement Agencies.

QUALIFICATIONS (MUST HAVE):

• A bachelor’s degree and a minimum of 2 years of related experience is preferred. Experience may be substituted for formal education.
• 2 years insurance background / terminology required.
• Demonstrated proficiency in Excel, Word, PowerPoint, and Microsoft Office required with the ability to type a minimum of 50 wpm.
• Extensive knowledge and use of internet based investigative resources such as Google searches, social media, Accurint, and TLO.
• The ability to remain highly productive in a changing environment, strong attention to detail and proof-reading skills, accuracy, and organizational skills is necessary.
• Able to effectively communicate using Phone and Internet Video to the claimant / subjects to set appointments for interviews.
• Must be able to communicate effectively and professionally; both verbal and written with excellent writing / grammar skills.
• Ability to work independently and as a team.

PREFERRED QUALIFICATIONS (NICE TO HAVE):

• Insurance administration experience
• Familiarity with California SIU regulations
• Develop and demonstrate a thorough understanding of insurance, investigative, and anti-fraud regulatory compliance terminology required to identify, organize, track, develop, and write reports.
• One or more of the following professional industry certifications:
• Certified Fraud Investigator (CFE)
• Certified Insurance Fraud Investigator (CIFI)
• Fraud Claim Law Associate (FCLA)
• Fraud Claim Law Specialist (FCLS)
• Certified Protection Professional (CPP)
• Associate in Claims (AIC)
• Chartered Property Casualty Underwriter (CPCU)

BENEFITS:

• Medical, dental, vision, basic life, AD&D, and disability insurance
• Enrollment in our company’s 401(k)plan, subject to eligibility requirements
• Seven paid holidays annually, sick days available where required by law
• Vacation time offered for full time positions. Unused vacation is only paid out where required by law.

Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have any questions regarding Equal Employment Opportunity, have difficulty using the online system and require an alternate method to apply, or require an accommodation at any time during the recruitment and/or employment process, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.

Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have any questions regarding Equal Employment Opportunity, have difficulty using the online system and require an alternate method to apply, or require an accommodation at any time during the recruitment and/or employment process, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.