State Licensed SIU Investigator

Job Summary

A company is looking for a SIU Investigator to conduct in-depth investigations of accident and health insurance claims involving potential fraud.

Key Responsibilities

• Makes claim decisions regarding complex investigations and pursues restitution
• Manages, researches, and resolves complex customer communications and issues
• Conducts thorough investigations of potentially fraudulent multi-discipline claims

Required Qualifications

• Strong background in insurance claims
• Experience in reviewing medical claims
• Ability to conduct background searches and interviews
• Knowledge of analyzing medical notes and bills
• Experience in substantiating suspected fraudulent activity