Claims SIU Senior Investigator (remote)

It’s ok if you don’t meet every requirement. At Grange, we prioritize creating a diverse, equitable and inclusive workplace. If you're enthusiastic about this role but your previous experience only partially matches qualifications in the job description, we still encourage you to apply. We believe in fostering growth and providing opportunities for continuous learning and development of skills as you progress in your career with us.

Summary : This position is responsible for conducting and overseeing field investigations or desk investigations using internal and external resources while supporting Grange anti-fraud initiatives.

What You’ll Be Doing :

• Analyzes, monitors and conveys highly technical and at times sensitive information into actionable investigative strategies including the identification of complex case investigations.
• Disseminate relevant information regarding investigative techniques, practices, fraud trends and area alerts to internal customers and provide relevant investigative / fraud training.
• Assist the SIU management team as requested. This may include participation in audits, reviewing file closings, special projects, and assuming managers duties when needed.
• Work with SIU Leadership in developing, establishing, refining and continually improving SIU best practices and strategies.
• Work with Claims LOB (AMD, Casualty, Property, Commercial and Workers’ Comp.) on developing and implementing investigation best practices and guidelines. Additionally, work in a collaborative effort with the Claims LOB and SIU Leadership to define success measures that can be reviewed, analyzed and trended for continual improvements to the process.
• Provide feedback to other departments (Profit Centers, General Counsel, Marketing, Underwriting, etc.) regarding relevant issues that affect the company’s business.
• Display advanced knowledge of investigative techniques, policy interpretation, civil and criminal proceedings, and laws relating to insurance.
• Review referrals from multiple sources (Claims, UW, Agents, fraud analytics, etc.) for investigative merit, identify those referrals with fraud indicators and conduct appropriate investigations.
• Provide education, training, assistance and direction to the file handler for further claims handling for referrals that do not meet the criteria for opening.
• Utilize technology (ISO; local, state and federal public records; social network sites, internal policy systems; available forensic examinations, fraud analytics, ) in the investigative process.
• Plan and conduct required investigations, to include interviews (insured’s, claimants, witnesses, agents) conduct scene or vehicle inspections, conduct canvasses for witnesses, meet with authorities and expert vendors, etc.
• Appropriate utilization of field claims staff or vendors to assist with in-person investigation needs.
• Prepare complete, detailed, and accurate narrative investigative reports in a timely manner.
• Participate in Claims Committee by preparing a summary of the investigation, conduct an oral presentation of the facts, and participate in the associated roundtable discussion with (Profit Centers, Claims and Legal).
• Oversee and direct investigations by investigative, forensic or legal vendors and exercise expense control when utilizing same.
• Establish and maintain cooperative working relationships with local, state, and federal law enforcement, fire, and prosecutorial officials.
• Make individual case reports to appropriate agencies to meet compliance guidelines.
• Participate in area intelligence gathering meetings.
• Appear in court as company representative, as needed.
• Attend EUOs, either in person or via Zoom, with assigned Defense Counsel. Contribute appropriately, as needed by Counsel.
• Participate in Large Loss / Legal Roundtables by preparing appropriate timeline and submitting proper proofs.
• Identify fraud trends in the industry and formulate a plan of action to combat discovered fraud.
• Create and deliver relevant fraud training to each LOB on a monthly, weekly, quarterly or annual basis.
• Actively participates in industry fraud / trade association groups

What You’ll Bring To The Company :

Bachelor's degree or equivalent education and experience, plus a minimum of five years applicable investigative experience in Claims Department, law enforcement agency, or other investigative organization is preferred. A working knowledge of investigative techniques, rules of evidence and court procedures and the ability to travel upon immediate notice needed. Must be able to develop and follow leads to a logical conclusion and plan and conduct interviews of witnesses, insured’s or claimants to obtain information and evidence. Must possess the ability to maintain multi-case workload and adjust priorities as needed. Must possess excellent interpersonal, verbal and written communication skills. Must have a valid driver's license and good driving record and the ability to operate and maintain a company vehicle. State specific adjusters’ license may be required.

About Us :

Grange Insurance Company, with $ billion in assets and more than $ billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an Best rating of "A" (Excellent).

Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave.

Who We Are :

We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength. We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values : Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow.

Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity / race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals.

Our Diversity, Equity and Inclusion Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth. Together, we use our individual experiences to learn from one another and grow as professionals and as people.

We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.

Grange Enterprise is proud to be part of the CEO Action for Diversity and Inclusion, a national initiative of more than 1400 CEOs working for the advancement of diversity and inclusion within the workplace.