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At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.
*This position is eligible to work from home anywhere in the United States**
Essential Functions:
Promptly investigates and evaluates SIU referrals of moderate to high complexity, including organized ring activity Reviews claim, underwriting and premium audit files pertinent to the referral Initiates contact with other departments, insureds, claimants, witnesses, vendors, other carriers, attorneys, law enforcement or any others to obtain information Researches background information, including public records, claims history and social media sites Takes statements from insureds, claimants, witnesses and other pertinent parties.
Documents all special investigative handling and activity Reviews the facts of an investigation and completes field investigations Attends examinations under oath (EUOs) and depositions for assigned cases Secures and reviews bills, invoices, receipts and other documentation for legitimacy and accuracy Tracks trends and patterns of investigations regarding organized ring activity Provides status updates on special investigations to branch or corporate office team members, agents, defense counsel and law enforcement entities Identifies, investigates and pursues opportunities for recovery or restitution Develops and evaluates investigative data and evidence to formulate recommendations Conducts analysis of all investigative materials to formulate a recommendation for further handling, including payment, compromise or denial of a claim or rescission of a policy Prepares a special report with written summaries of all investigative data
Communicates with branch and corporate office departments, as well as other impacted entities, regarding investigative activities and evidence to support or exonerate potential fraud
Prepares documentation in compliance with a state’s anti-fraud reporting requirements on each investigation
Prepares evidence packets related to civil litigation or criminal prosecution for submission to defense counsel, National Insurance Crime Bureau (NICB), State Fraud Bureaus and/or Attorney General’s offices or other law enforcement entities
Develops assigned internal and external anti-fraud training and marketing of SIU services
Develops assigned internal and external anti-fraud training
Provides anti-fraud training to internal and external customers through investigative discussions and dissemination of educational materials
Collaborates with team members in developing marketing strategies for the SIU department and its services
Implements assigned marketing strategies
Participates in the establishment of effective policy standards, practices, techniques and procedures for the investigation, evaluation and disposition of the SIU referral. Maintains active involvement in professional associations within the industry.
Education & Experience:
Bachelor’s degree in business, insurance, criminal justice or related field or equivalent relevant experience
Five years of claims adjusting, investigation or insurance experience or related experience
Prior property and casualty experience preferred
Fraud Claim Law Specialist (FCLS) designation within the first year of hire
Insurance designations, such as INS or AIC, preferred
Knowledge, Skills & Abilities:
Strong knowledge of the investigative process, including proper identification and collection of physical evidence
Strong knowledge of civil and criminal investigative procedures and the legal system
Strong knowledge of various statement taking techniques, collection and analysis of public and private records
Good knowledge of property and casualty insurance industry and fraud awareness preferred
Strong investigative skills and ability to make sound decisions
Good conflict resolution, negotiation and facilitation abilities
Ability to work independently and as part of a team
Strong verbal and written communication skills, including file documentation and report writing
Good knowledge of computers and Microsoft Office Suite
Attendance of the National Insurance Crime Bureau SIU Academy within the first two years of hire
Occasional travel; a valid driver’s license with an acceptable motor vehicle report per company standards required if driving
Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $75,910.79 - $97,485.70. The hiring range for other locations may vary.
The hiring salary range for this position will vary based on geographic location, falling within either of the following:
$78,726 - $108,771 or $87,008 - $119,646 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.
For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers .
Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.
All of our locations are tobacco free including in company vehicles.
