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Senior Investigator
2 months ago
USAA is seeking a highly skilled and experienced Senior Investigator to join our team. As a Senior Investigator, you will play a critical role in protecting USAA and our members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact.
Key Responsibilities- Lead the execution of fraud prevention strategies and investigative operations.
- Lead high exposure, high profile, and critical work assignments, and special investigations involving sophisticated niche fraud referrals.
- Apply advanced knowledge of property and casualty insurance industry products, services, and processes in investigating claims.
- Apply advanced knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
- Process large quantities of unstructured detailed information with high levels of accuracy by collecting evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
- Make appropriate and prompt decisions to identify potential complex fraud within defined guidelines.
- Prepare and present detailed and comprehensive verbal and written investigative reports summarizing the results and outcome of the investigation.
- Serve as subject matter authority for team members, including providing expert mentorship and training for fraud investigations.
- Develop and maintain external relationships with industry, law enforcement, and other contacts involved in fraud investigation, detection, and prevention.
- Develop proactive actions and convey compelling arguments to influence disposition of arbitrated and litigated cases effectively and efficiently.
- Handle CAT duty responsibilities as business requires.
- Ensure risks associated with business activities are effectively identified, measured, supervised, and controlled in accordance with risk and compliance policies and procedures.
- High School Diploma or General Equivalency Diploma.
- 4 years of property and casualty SIU/fraud investigation experience; OR 6 years relevant fraud industry investigation experience.
- Expert knowledge and understanding of fraud investigations, as well as application of case law and state laws and regulations.
- Must be a skilled investigator with experience taking sophisticated statements from multiple parties to an event.
- Ability to capture a broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
- Demonstrated ability to coordinate and prioritize workload, performing multiple tasks and devising solutions to problems.
- Experience using computers and various software packages to enter and extract data for analysis from relevant data sources and systems.
- Knowledge of city, state, and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology.
- Experience in concurrent handling of specialty/complex/litigated claims/cases, as well as mediation/arbitration/trial preparation and participation.
- Experience investigating staged accidents and reviewing medical bills.
- At least 5 years of SIU/investigative experience in property and casualty.
- Experience working in projects within SIU.
- Experience leading or mentoring other SIU investigators.
USAA offers a competitive salary range of $81,770 - $156,290, based on experience and market data. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
USAA also offers a comprehensive benefits package, including medical, dental, and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays, and various wellness programs.
