Job Description
Job Type: Permanent
Build a brilliant future with Hiscox The Team: The Claims SIU Investigator will report directly to the Claims SIU Manager. These individuals will both be integral members of the Claims Compliance and Shared Services Team- which oversees claims related compliance, quality assurance (QA), subrogation, risk identification, and fraud prevention strategies. The Compliance and Shared Services team centrally manages fraud referrals, along with owning and improving the business processes and technical solutions to proactively identify and prevent fraud.
We currently work in a Hybrid remote-office work setting, it is expected the Claims SIU Investigator will report to the office for (2) days, with the ability to work remotely for (3) days. This work setting is subject to change, depending on business needs. Position can be based at one of the following hub office locations:
- Atlanta, GA
- Chicago, IL
- Manhattan, NY
- Scottsdale, AZ
- White Plains, NY
- West Hartford, CT
The Role: The Claims SIU Investigator will assist in identifying and mitigating risks associated with fraudulent claims. This individual will analyze and investigate claims that have been referred to the Claims Special Investigation Unit (Claims SIU) for potential fraud.
Additional core responsibilities include, but are not limited to, the following:
- Validate the facts of loss and coordinate the investigation of Claims SIU referrals
- Conduct background searches, coordinate scene investigations, take statements, review and analyze claim documentation, coordinate/conduct witness interviews, complete social media searches, and coordinate surveillance
- Enter SIU data and claim information into business systems, validate fraud outcomes based on investigations, prepare detailed verbal and written investigative reports summarizing results and recommended actions
- Collaborate with the Claims SIU Manager, external SIU vendors, and business partners regarding investigative assignments
- Utilize analytic tools and data to identify claims for investigation or for supporting evidence of fraud and damages
- Build and maintain relationships with internal and external stakeholders (NICB, DOI, SIU and Law Enforcement)
- Obtain and summarize claim files acquired from other insurers in support of open SIU investigations
- Assist the Claims SIU Manager with providing stakeholder training, along with promoting Fraud Awareness to the Claim's Department and Business Partners
- Ensure compliance with state fraud-related laws and regulations
Our must-haves: - Minimum 5 years of Analytical/Investigative experience in insurance or related field
- Bachelor's degree or equivalent work experience
- Fraud Claims Law Specialist (FCLS), Fraud Claims Law Associate (FCLA) Certified Fraud Examiner (CFE) and/or IASIU Certified Insurance Fraud Investigator (CIFI), designation preferred
- Proficiency with external database tools such as ISO, social networking platforms and Internet searching
- The ability to identify and recognize red flags in data
- Extensive knowledge and experience in all levels of claims investigation, fraud investigation, and regulatory reporting requirements
Additional Factors Considered - Subject matter expertise
- Experience within legal or regulatory compliance
- Experience with state DOI standards
- Track record of exceptional customer service
What Hiscox USA Offers - 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short- term disability and long-term disability coverage
- 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Company paid subscription to Headspace to support employees' mental health and wellbeing
- 2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program
- Dynamic, creative and values-driven culture
- Modern and open office spaces, complimentary drinks
- Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
About Hiscox As an international specialist insurer we are far removed from the world of mass market insurance products. Instead we are selective and focus on our key areas of expertise and strength - all of which is underpinned by a culture that encourages us to challenge convention and always look for a better way of doing things.
We insure the unique and the interesting. And we search for the same when it comes to talented people. Hiscox is full of smart, reliable human beings that look out for customers and each other. We believe in doing the right thing, making good and rebuilding when things go wrong. Everyone is encouraged to think creatively, challenge the status quo and look for solutions.
Scratch beneath the surface and you will find a business that is solid, but slightly contrary. We like to do things differently and constantly seek to evolve. We might have been around for a long time (our roots go back to 1901), but we are young in many ways, ambitious and going places. Some people might say insurance is dull, but life at Hiscox is anything but. If that sounds good to you, get in touch.
About Hiscox US Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.
Today, Hiscox USA has a talent force of about 420 employees operating out of several major cities - New York, Atlanta, Chicago, Scottsdale, Los Angeles and West Hartford. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.
Salary range: $80k-$135k
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance)#LI-AJ1
Work with amazing people and be part of a unique culture Hiscox Ltd
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