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SIU Investigator, Inside-Based - Remote

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Remote

Employer:  CSAA Insurance Exchange
Category:  Customer Service
Job Type:  Full Time

Description

CSAA Insurance Group (CSAA IG), a AAA insurer, is one of the top personal lines property and casualty insurance groups in the U.S. Our employees proudly live our core beliefs and fulfill our enduring purpose to help members prevent, prepare for and recover from life's uncertainties, and we're proud of the culture we create together. As we commit to progress over perfection, we recognize that every day is an opportunity to be innovative and adaptable. At CSAA IG, we hire good people for a brighter tomorrow. We are actively hiring for an SIU Investigator, Inside Based! Join us and support CSAA IG in achieving our goals.

Your Role:

Exercises independent judgment pertaining to the investigation and handling to resolution of high-exposure SIU property/automobile/casualty claims in low-density markets. Claims handled range from more simple fraud cases to those of the highest levels of complexity and risk. Collaborates and interacts with center-based claims staff in the review of suspected fraudulent claims. Serves as Subject Matter Expert for large-exposure property and casualty claims. Acts as liaison to the insurance industry and law enforcement, and refers suspected fraudulent claims to Departments of Insurance and/or Attorneys General. Assists with file reviews and assignment triage. Actively contributes to SIU training.

Your work:

  • Investigation, analysis and dispute of suspected fraudulent claims in multiple states
  • Performs claim review data research, case analysis and formulation of actual investigative strategy/plan.
  • Investigates background and history on claims.
  • Takes statements and collects written documents; analyzes information; and determines if fraud exists in claim.
  • Determines the need for and engages investigators, attorneys and expert witnesses and independent adjuster private investigators.
  • Analyzes underwriting and sales documentation.
  • Analyzes legal and medical documents.
  • Evaluates and makes recommendations for all assigned cases.
  • Regularly determines final resolution of majority of cases up to $35,000 settlement authority.
  • At conclusion of evaluation, independently negotiates claim with claimant, claimant's attorney, medical providers, other insurance companies, etc. to reach final resolution.
  • Recommends course of action and seeks approval authority from supervisor or manager as appropriate on cases above settlement authority or involving contractual benefits.
  • Legal/litigation
  • Responsible for management through conclusion, including trial, of litigated claims, including auto first- and third-party and homeowner claims.
  • Participates in legal activities: oversees defense counsel and experts; and represents and testifies on behalf of the company in criminal, civil and small claims court.
  • Attends settlement conferences via telephone.
  • Regulatory
  • Reports suspected fraudulent claims to appropriate authority according to regulations.
  • Industry trends/best practices, volunteer projects and personal development
  • Represents CSAA IG to and exchanges information with the external SIU community to identify possible relevant trends pertaining to cases.
  • Facilitates and coordinates special projects involving peers, outside companies and agencies.

Required Experience, Education and Skills

  • Bachelor's degree in related area or an equivalent combination of education and experience
  • 5+ years of experience handling complex claims, preferably in multiple claims disciplines, i.e., Auto, Casualty/PIP/MP, Homeowner's Property, etc.
  • Depending on assignment, may be required to obtain and maintain Adjuster's license (state-specific)
  • Valid driver's license
  • Knowledge of state and federal insurance regulations and all lines of business coverages
  • Strong investigative and negotiation skills
  • Strong written and oral communication and presentation skills
  • Strong analytical skills
  • Effective time management skills
  • Proficient computer skills
  • Thorough knowledge and understanding of property and casualty claims handling processes and procedures
  • Ability to analyze claims to identify fraud indicators and trends
  • Extensive understanding of statutory and regulatory requirements and ability to develop proficiency in standards of civil procedure
  • Ability to travel and work extended hours and/or weekends

What would make us excited about you?

  • CPCU certification
  • Litigation experience
  • SIU experience, a plus
  • Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.)
  • Lives into cultural norms (e.g., willing to have cameras when it matters: helping onboard new team members, building relationships, etc.)
  • Travels as needed for role, including divisional / team meetings and other in-person meetings
  • Fulfills business needs, which may include investing extra time, helping other teams, etc

CSAA IG Careers

At CSAA IG, we're proudly devoted to protecting our customers, our employees, our communities, and the world at large. We are on a climate journey to continue to do better for our people, our business, and our planet. Taking bold action and leading by example. We are citizens for a changing world, and we continually change to meet it.

Join us if you...

  • BELIEVE in a mission focused on building a community of service, rooted in inclusion and belonging.
  • COMMIT to being there for our customers and employees.
  • CREATE a sense of purpose that serves the greater good through innovation.

Recognition: We offer a total compensation package, performance bonus, 401(k) with a company match, and so much more! Read more about what we offer and what it is like to be a part of our dynamic team at https://careers.csaa-insurance.aaa.com/us/en/benefits

In most cases, you will have the opportunity to choose your preferred working location from the following options when you join CSAA IG: remote, hybrid, or in-person. Submit your application to be considered. We communicate via email, so check your inbox and/or your spam folder to ensure you don't miss important updates from us.

If a reasonable accommodation is needed to participate in the job application or interview process, please contact TalentAcquisition@csaa.com.

As part of our values, we are committed to supporting inclusion and diversity at CSAA IG. We actively celebrate colleagues' different abilities, sexual orientation, ethnicity, and gender. Everyone is welcome and supported in their development at all stages in their journey with us.

We are always recruiting, retaining, and promoting a diverse mix of colleagues who are representative of the U.S. workforce. The diversity of our team fosters a broad range of ideas and enables us to design and deliver a wide array of products to meet customers' evolving needs.

CSAA Insurance Group is an equal opportunity employer.

The national average salary range for this position is $80,820 - $89,800. However, we have a location-based compensation structure. Our salary ranges vary and are calculated based on county of residence. The full salary range for this position across all the states we hire in is $72,810 - $107,900. This role also includes an opportunity for a company-wide annual discretionary bonus, through our Annual Incentive Plan (AIP), of up to 8% of eligible pay.

If you apply and are selected to continue in the recruiting process, we will schedule a preliminary call with you to discuss the role and will disclose during that call the available salary/hourly rate range based on your location. Factors used to determine the actual salary offered may include location, experience, or education.

Must have authorization to work indefinitely in the US.

Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska.

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Colorado Specific Job Range :
$84,960.00 - $94,400.00
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