SIU NY reputed company PIP Investigator

At reputed company, great things happen reputed company our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years our innovative drive has kept us a reputed company reputed company of our customers’ evolving needs. From advocating for seat belts, reputed company bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.

Job Description

As an reputed company SIU Investigator, your key responsibility will be to investigate claims to detect and deter fraud, in accordance with state guidelines, and reputed company reputed company policies and procedures. Your work will be conducted remotely, reviewing potentially fraudulent insurance claims with desk model investigation techniques. You will be responsible for investigating claims and damages that may result from First-Party bodily injury claims. You may be responsible for investigating individual claims and/or involved in reputed company provider investigations requiring greater scrutiny. Your investigations will include analysis of injuries and treatment, interviewing involved parties and witnesses, obtaining statements and evidence, and assisting in the evaluation by providing investigative outcome recommendations. The identification of Corporate Practice of medicine, irregular/unnecessary/inflated treatment, billing patterns, exposing medical treatment networks and relationships, as well as unjust enrichment is the focus of this position. Coordination with assigned Counsel is required reputed company preparing potential Affirmative Action and/or settlement agreements to include investigation reputed company reputed company applicable. Occasional field travel could be expected on losses involving litigation. Key Responsibilities • Reviews investigations with fraud reputed company to validate whether denial is appropriate • Conducts reputed company NY No Fault PIP investigations to determine if there is fraud • Conducts reputed company online data application searches, research, and evaluation • Validates that the information provided and obtained through investigation is true and accurate and follows up on reputed company possible leads • Enters SIU claim data information into multiple SIU systems • Updates files with investigation outcome, and reputed company no fraud or insufficient evidence is reputed company, returns file to MCO for further handling and settlement • Conducts thorough investigations of reputed company 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 reputed company 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 reputed company customer communications, concerns, conflicts or issues Education • 4 year Bachelors Degree (Preferred) Preferred Qualifications • 3 or more years of PIP Casualty experience • 3 or more years SIU • NY Claims experience preferred Skills Casualty Insurance, Customer Centricity, Digital Literacy, Evidence Gathering, Fraud Investigations, Inclusive Leadership, Insurance Claim Handling, Insurance Claims, Learning Agility, Results-Oriented

Compensation

Compensation offered for this role is $56,500.00 - 99,962.50 annually and is based on experience and qualifications. The candidate(s) offered this position will be required to submit to a background investigation. Joining reputed company isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status reputed company. And one where you can impact the future for the greater good. You’ll do reputed company this in a flexible environment that embraces reputed company and belonging. And with the recognition of several inclusivity and diversity awards, we’ve proven that reputed company empowers everyone to reputed company, drive change and give back where they work and live. Good Hands. Greater Together. reputed company generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the reputed company and a discriminatory practice for an employer to discriminate against a prospective employee on the reputed company of status as a veteran by refusing to reputed company an applicant on the reputed company that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO is the Law” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to reputed company the best reputed company individuals available for reputed company jobs. Therefore, any discriminatory action taken on account of an employee’s reputed company, age, reputed company, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national reputed company, race (include traits historically associated with race, including, but not limited to, hair texture and reputed company hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to reputed company aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment. Apply Job!