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SIU Examiner

Safepoint MGA, LLC

New Orleans, LA

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JOB DETAILS
JOB TYPE
Full-time
SKILLS
Analysis Skills, Claims Processing, Coaching, Communication Skills, Compensation and Benefits, Computer Music and Audio, Database Analysis, Detail Oriented, Disability Insurance, Documentation, Flexible Spending Accounts, Fraud Investigation, Information/Data Security (InfoSec), Insurance, Law Enforcement, Microsoft Office, Microsoft Product Family, Office Equipment, Organizational Skills, People Management, Physical Demands, Property and Casualty Insurance, Reporting Skills, Research Skills, Search Ranking, State Laws and Regulations, Training/Teaching, Trend Analysis, Vehicle Driving, Work From Home, Writing Skills
LOCATION
New Orleans, LA
POSTED
30+ days ago
Safepoint Insurance is an admitted Property and Casualty Insurance carrier. We are based in Tampa, FL. We are looking for an SIU Examiner in Louisiana. Our Claims Department is growing and we are looking for self-motivated professionals ready to support our organization.


Job Summary
Responsible for identifying and handling of all aspects of claims fraud investigations. Provides expertise and claim support in reviewing SIU reported claims to include claims analysis, research, investigation, and recommendations for further handling. Coordinates SIU training with associates. 

Duties and responsibilities
  • Receive referrals on questionable claims or other transactions, determine if further investigation is warranted and formulate a plan of action to handle if referral accepted.
  • Conduct investigation of assigned questionable claims including recorded interviews, database searches and evaluation of evidence necessary to determine the legitimacy of a claim.
  • Provide reports to management and assigned examiners as to findings and possible recommendations.
  • Coordinate investigations with approved SIU investigators and experts when necessary and provide guidance as needed.
  • Provide coaching, direction and training to associates in the realm of SIU investigations.
  • Analyze and identify trends from the claims data and provide reports when necessary.
  • Provide 626 requests to other carrier’s 626 designees and respond to 626 requests from other carriers.
  • Stay current on regulations and state laws. Develops fraud detection and prevention programs.
  • Works with State DFS contacts and NICB.


Essential Functions
  • Ability to think critically, identify, and investigate fraudulent activity and claims
  • Ability to communicate verbally and in writing
  • Ability to continuously research state regulations
  • Ability to convey knowledge to associates
  • Ability to determine appropriate course of action in fraudulent cases

Qualifications
  • Louisiana Resident Adjuster License and ability to obtain and maintain reciprocal licensure for applicable states
  • Associate’s Degree required; Bachelor’s Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree.
  • At least 5 years of experience with a law enforcement agency or property claims handling experience.
  • Demonstrated ability to research and conduct proactive investigations.
  • Proficiency with Microsoft Office products required.
  • Excellent communication skills, ability to interact on a professional level with internal and external personnel and partners.
  • Ability to work independently in a fast-paced environment.
  • Detail-oriented and exceptionally organized.

Physical requirements
While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to sit; stand; walk; use hands to grasp or feel; and reach with hands and arms, drive a vehicle

Working conditions
This position is performed remotely from a home office environment. This requires the use of standard office equipment, including computers and audio devices. Employees must maintain a reliable high-speed, password protected internet connection and a quiet, professional workspace that allows for uninterrupted work during scheduled hours. The position also requires the ability to safeguard and maintain confidentiality and security of sensitive information while working remotely.

Safepoint MGA, LLC does not offer immigration sponsorship or support for this role. This includes serving as the immigration employer of record or providing documentation or assistance for work authorization processes now or in the future, including H-1B, OPT, STEM OPT, CPT, J-1, etc.

Compensation and Benefits
We recognize that talented professionals are attracted to companies that provide a great place to work, combined with a comprehensive and competitive pay and benefits package, along with opportunities for personal growth and job advancement. For this reason we are pleased to provide:
  • Market Competitive Wages commensurate with experience
  • Prof. Development and Educational Assistance Programs
  • Safe Harbor 401K Plan with Immediate Vesting and an Automatic Company Contribution
  • Paid Time-Off (Discretionary, PTO, Parental Leave, and others)
  • Company Paid Holidays
  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Short and Long Term Disability Insurance (company paid)
  • Flexible Spending Accounts with Company Contribution
  • Health Savings Accounts with Company Contribution
  • Employee Life and AD&D Insurance
  • Dependent Life and AD&D Insurance
  • Company paid AAA Membership
  • Company paid Identity Theft Protection
  • Other Ancillary Insurance Benefit Programs
  • And more…
Safepoint Insurance is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Safepoint depends solely on your qualifications.

 

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Safepoint MGA, LLC

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