
SIU Field Investigator
- Yonkers, NY
- $55,500-75,903 per year
- Permanent
- Full-time
- Reviews investigations with fraud outcomes to validate whether denial is appropriate
- Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
- Conducts complex online data application searches, research, and evaluation
- Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
- Enters SIU claim data information into multiple SIU systems
- Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement
- Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed
- Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages
- Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process
- Researches and responds to complex customer communications, concerns, conflicts or issues
- 4 year Bachelors Degree (Preferred)
- 2 or more years of experience (Preferred)
- This job does not have supervisory duties.