ICW Group - Risk Management Welcome Letter, California

Special Investigations Unit (SIU) Investigator

Location San Diego, CA State CA Job Description The purpose is to detect, prevent, and investigate suspected fraudulent claims, to limit exposure, and protect company assets. Responsibilities include:

Maintain a systematic and effective method to detect and investigate suspected fraudulent claims and provide for their appropriate disposition.  Evaluate all referrals for fraud and ensure essential data is located and documented

 Ensure investigative results are acted upon and measure ROI of same

 Utilize multiple online resources to detect, deter, and defeat fraud.

 Educate and train claim handlers, underwriters and integral insurance personnel to identify possible insurance fraud

Provide investigative guidance and data to assist in investigations.  Locate, extract, analyze, and organize critical data from multiple systems to prevent and detect fraud

 Experienced with Excel and in data presentation to assist in detecting, deterring and defeating fraud

 Ensure the accuracy, quality, and timeliness of the evidence gathered.

 Understand applicable laws, legal codes, court procedures, precedents, government regulations, executive orders, and agency rules for effective investigations

 Prepare and present completed investigations to appropriate senior staff and/or criminal justice personnel in a highly professional manner

Provide superior communication, customer service and ensure relationship building with all integral personnel including Examiners, Risk

Insurance Company of the West | Explorer Insurance Company | VerTerra Insurance Company www.icwgroup.com | 800.877.1111 Management, Auditors, Hearing Reps, Marketing, Underwriting, Claimants, Policyholders, Agents, Brokers, SIU, Legal and Medical professionals, Government/Regulatory Agencies, law enforcement and Vendors.  Facilitate effective communications with regulatory and enforcement agencies.

 Coordinate vendors to ensure appropriate outcomes and efficient pricing

May perform other duties as assigned.

Requirements Bachelor's degree (B. A. or B.S.) from four-year college or university or equivalent combination of education and experience with a minimum 2- year college degree in criminal justice or insurance claim experience.

Working level knowledge of insurance and claim operations, commercial, personal, and Workers Compensation insurance products. 2-5 years SIU, legal, claims and/or law enforcement experience.

Demonstrated abilities in: identifying persons or organizations involved in suspicious claims activities; working independently under minimal supervision; maintaining a strong work ethic and exercising initiative; communicating effectively both verbally and in writing.

Proficient in the use of a personal computer, including MS Word, MS Excel, MS Outlook and able to learn various proprietary computer applications.

If you are interested please apply online using the link below. https://rew22.ultipro.com/INS1011/JobBoard/JobDetails.aspx?__ID=*4FC044B972533C3C

Insurance Company of the West | Explorer Insurance Company | VerTerra Insurance Company www.icwgroup.com | 800.877.1111