Workers Compensation SIU Field Investigator (Finance)

JOB DESCRIPTION

Workers Compensation SIU Field Investigator

Job Title: Workers Compensation SIU Filed Investigator

Area of Interest: Insurance-Claims-SIU

Countries: USA

State: New York

Job Description:

Chubb is currently seeking a Workers Compensation SIU Field Investigator to join our team working in the State of New York. This individual will be responsible for investigating Workers Compensation claims to assist our team in making informed claim decisions.

Position Responsibilities:

As a critical part of the Workers Compensation Claim discipline, this position is responsible for collaborating with internal and external customers to:

• Analyze first reports of loss, underlying file material, and/or underwriting file, to determine if claim is suspect or potentially fraudulent.
• Conduct a complete, in-depth investigation to develop sufficient evidence to make the appropriate claim handling decision.
• Recommend a final course of Claim action including the substantiation of legitimate claim, or denial of an unjustified claim, and/or a recommendation of further punitive action to successfully execute the above.
• Collaborating and communicating with the following during the investigation: Claim Department, Claim Operations, Loss Control Department, Underwriting Departments, Agents, Defense Counsel, Insured's, SIU Manager, Law Enforcement, Regulatory Agencies, and Industry Anti-Fraud Organizations
• Establishing strong business relationships and delivering exceptional customer service.
• Maintaining and monitoring an active diary, properly documenting all developments in claim file, preparing investigative reports, maintaining suspicious claim database, and preparing reports on a quarterly basis to SIU management.
• Be familiar with and adhere to all State fraud statutes.
• Actively pursue memberships in professional Anti-Fraud investigative organizations and participate in associated training and events offered.
• Develop and provide fraud awareness training to internal and external customers.

Knowledge & Skills:

• Candidate should possess a minimum of 5 years of experience as an Investigator with an insurance carrier, law enforcement or the US military. Workers Compensation insurance investigation experience is a plus.
• High level of acumen in the areas of investigation, listening, strategic/analytical thinking, problem solving, and innovative thinking
• Strong knowledge of general industry trends and legislative activities regarding fraudulent claim handling, tort reform, fraud statutes, and civil/criminal procedures
• Clear interest in and quality execution of "deeper" level investigations
• Strong interpersonal/ relationship skills- proven ability to build and maintain excellent customer relationships in all situations; success with being a positive "face" to customers; ability to investigate through relationships; acumen to build and maintain successful relationships with internal colleagues as well as local law enforcement, attorney general employees, and insurance bureaus.
• Proficiency with Microsoft Outlook, Microsoft Word, Microsoft Excel is needed.
• The candidate must have excellent verbal and written communication skills.

QUALIFICATIONS

Knowledge

ABOUT US

Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.