SIU Investigator Job at Allied Universal® (Chattanooga)

Senior Director of Operations - PACE

Advance Your Career in Insurance Claims with Allied Universal® Compliance and In...

Location

United States , Dallas

Salary:

Not provided

Allied Universal®

Expiration Date

Until further notice

Requirements

Must possess one of the following: Bachelor’s degree in Healthcare Administration, Nursing, or Business
Associate’s degree in Healthcare Administration, Nursing, or Business and a minimum of eight (8) years of related experience in a healthcare leadership role
Minimum of three (3) years managing or directing an SIU insurance investigation program
Minimum of six (6) years of experience in a progressive healthcare leadership role
Ability to think strategically, make timely decisions and implement change
Ability to remain highly productive in a changing environment, possess strong attention to detail and well-developed organizational skills, and maintain a high level of discretion
Demonstrated proficiency in using subscription databases to search for relevant information on investigative assignments in support of the technical and professional staff of the SIU
Outstanding written and oral communication skills
Proficiency in Microsoft Outlook, Excel, Word, and PowerPoint

Job Responsibility

Oversight of SIU (Special Investigative Unit) Investigations team associated with the PACE contract
Use independent judgment to define and confirm client objectives (including due dates) on all new, reopen, and investigative referral cases
Provide consultation to the client using independent discretion to develop and implement an efficient, effective, and ethical investigation of an insurance claim
Ensure adherence to clear guidelines regarding company policies on privacy, compliance, and ethics
Ensure independently that the investigators assigned to complete the investigative tasks requested by the client have been given clear instruction on the client’s expectations at the time the case is approved
Maintain quality control after investigation is completed, ensuring that all client’s objectives have been addressed and achieved, and the billing applied to this work product falls within the standard billing schedule or client contract rates
Ensure team meets “reopen” sales goals on a monthly basis, creating accurate funding records for all items billable to the client
Use sound management, discretion, and independent judgment to resolve conflicts between clients and/or investigators
Handle customer complaints (negotiating as needed) and forward field operational issues to appropriate Vice President as needed
Provide daily updates to the clients within one business day after an investigative task has been completed, or per the client’s updating protocols set forth in a contract (if applicable)

What we offer

Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law
Employee Assistance Program
Employee Discount Program
Tuition Discount Program
Training & Career Development Programs

Fulltime

New

SIU / Surveillance Investigator

Allied Universal® is hiring a Special Investigations Unit (SIU) Investigator. Sp...

Location

United States , Minden

Salary:

Not provided

Allied Universal®

Expiration Date

Until further notice

Requirements

Private Investigator’s license required prior to applying
Must possess a valid driver's license with at least one year of driving experience
Must possess one or more of the following: Bachelor’s degree in Criminal Justice OR High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud
Ability to be properly licensed as a Private Investigator as required by the state where work Is completed
Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims
Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area.
Proficient in utilizing laptop computers and cell phones.
Special Investigative Unit (SIU) Compliance knowledge
Ability to type 40+ words per minute with minimum error

Job Responsibility

Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers’ compensation, general liability, property and casualty and disability
Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance
Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed
Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct
Run appropriate database indices if necessary and verify the accuracy of results found
Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor

What we offer

Medical, dental, vision, basic life, AD&D, and disability insurance
Enrollment in our company’s 401(k)plan, subject to eligibility requirements
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions

Fulltime

New

SIU / Surveillance Investigator

Allied Universal® is hiring a Special Investigations Unit (SIU) Investigator. Sp...

Location

United States , Alexandria

Salary:

Not provided

Allied Universal®

Expiration Date

Until further notice

Requirements

Private Investigator’s license required prior to applying
Must possess a valid driver's license with at least one year of driving experience
Must possess one or more of the following: Bachelor’s degree in Criminal Justice
High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud
Ability to be properly licensed as a Private Investigator as required by the state where work Is completed
Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims
Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area.
Proficient in utilizing laptop computers and cell phones.
Special Investigative Unit (SIU) Compliance knowledge

Job Responsibility

Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers’ compensation, general liability, property and casualty and disability
Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance
Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed
Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct
Run appropriate database indices if necessary and verify the accuracy of results found
Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor

What we offer

Medical, dental, vision, basic life, AD&D, and disability insurance
Enrollment in our company’s 401(k)plan, subject to eligibility requirements
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions

Fulltime