SIU Major Case Investigator, Commercial Claims

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Job Title

SIU Major Case Investigator, Commercial Claims

Requisition Number

R7106 SIU Major Case Investigator, Commercial Claims (Open)

Location

Colorado - Home Teleworkers

Additional Locations

Alabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers { 20 more}

Job Information

We're Mobilitas, a commercial insurance company created by CSAA Insurance, a AAA Insurer. Our mission is to reinvent commercial insurance in the mobility space by providing technologically advanced solutions for today’s way of doing business. At Mobilitas, we believe in what's possible, we use our inventive skills to create new opportunities - we're not chasing the status quo, we're chasing a shared vision. We’re looking for motivated, innovative individuals who think big, move fast and are dedicated to creating a company from the ground up, without the constraints of a traditional insurance company. We’re excited to push the boundaries of commercial insurance and are looking for enthusiastic team members to help us reimagine insurance. We are actively hiring for a SIU Major Case Investigator.

Your Role:

The SIU Major Case Investigator is accountable for identifying, investigating, and mitigating sophisticated fraud schemes, particularly those involving fraud rings in the TNC space. Leveraging a deep understanding of emerging technologies and analytical techniques, the role will work to combat fraud effectively within the Mobilitas ecosystem.

Your Work:

• Focusing on organized fraud rings, develops and implements strategies to detect and prevent fraud activities, focusing on attorney-provider networks.
• Collaborate with internal technology teams to design and refine fraud detection tools and methodology.
• Conduct detailed investigations into suspected fraud cases and compile findings into reports for further action within Mobilitas and external agencies.
• Makes key decisions regarding the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity.
• Stay updated with the latest trends in fraud schemes and countermeasures.
• Provide training and guidance to other team members on best practices for fraud detection.
• Work closely with regulatory and law enforcement agencies to stay up to date on all fraud detection measures.
• Complies with local, state, and federal statutes regarding proper, timely, and ethical insurance investigations.
• Acts as a liaison with local/state/federal law enforcement personnel, industry advocates and other companies.
• Serves as the subject matter expert (liaison) on fraud to business and industry partners.
• Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation.
• At times may also handle non-ring investigations as needed.

Required Experience, Education and Skills:

• 7-10 years of experience handling complex claims, preferably in the commercial auto environment.
• High School Diploma/GED or 7 years of relevant work experience in claims and fraud investigation
• Depending on assignment, may be required to obtain and maintain Adjuster's license (state-specific).
• Strong analytical and problem-solving skills.
• Proficient in using advanced data analytics tools and software with industry specific technology (i.e. Lexis Nexus, ISO Claims Search, Network Analytics).
• Advanced Excel skills (pivot tables, formulas).
• Excellent attention to detail and the ability to manage multiple investigations simultaneously.

What would make us excited about you:

• BA/BS in finance, criminal justice or another related field.
• Industry certifications, such as the CIFI, CIFA, CFE, or FCLS.
• Criminal investigation or fraud detection experience.
• Experience in building out data sets in anticipation of/preparation for RICO filings, to include medical and billing information.
• Experience in constructing/maintaining a fraud identification model.
• 5 years of advanced data analysis.
• Knowledge of available resources (internal and external) to assist in investigations.
• Time management skills.
• Proficiencies in accurate reporting, presentation, and training.
• Understanding of claim best practices.
• Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.).
• Fulfills business needs, which may include investing extra time, helping other teams, etc.

Mobilitas Careers

At Mobilitas, 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 careers.mobilitasinsurance.com.

In most cases, you will have the opportunity to choose your preferred working location from the following options when you join us: 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 jobs@mobilitasinsurance.com.

As part of our values, we are committed to supporting inclusion and diversity. 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.

Mobilitas is an equal opportunity employer.  

The national average salary range for this position is $89,910 - $99,900. However, we have a location-based compensation structure. Our salary ranges vary and are calculated based on county of residence. The full salary for this position across all the states we hire in is $80,820 - $119,800.  This role also includes an opportunity for a company-wide annual discretionary bonus, through our Annual Incentive Plan (AIP), of up to 10.0% 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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Salary : $80,820 - $119,800