Job details
Job type full-time
Not provided by employer
Full job description
Job details
Job location
Corporate office - boca raton, fl
Remote type
Fully remote
Position type
Full time
Job shift
Day
Position summary:
Reports to siu manager, position will conduct analytical research to identify trends and patterns of suspicious claim activityThis position is responsible for acquiring and analyzing complex intelligence and investigative data, using deductive reasoning and compilation/organization of investigative factsThis is a remote mid-level remote position located in the boca raton office with some travel required.
Essential functions:
Responsibilities include the ability to review, analyze, triage, and manage investigations within the siu databasesUpdate and maintain all statistics/metrics associate with siu referrals and investigationsCollect, collate, analyze, dissemination and evaluate data used to discover developing patterns trends and changes in suspicious activityPerform strategic, prescriptive analysis using statistical data, time series analysis, link analysis, maps, and other tools to view, evaluate and generate conclusionsPrepare written reports, to include visualizations of data for purposes of data exploration and to gain insight through analyticsPrioritize and identify patterns and trends of suspicious activity or other indicatorsStratify and classify data and maintain intelligence information for use by siu staffAssist siu investigators with criminal intelligence and data when applicableIdentify known trends and other suspicious activity developed from in house claims reviews and analysisParticipate in investigative strategy development meetingsInteract with others within the organization to secure and coordinate data/information necessary to formulate a strategic plan for investigating organized fraud rings/trendsConduct basic background investigations to include social media and other platformsThe ability to work with other departments and respond to questions and inquires.
Responsible to generate and respond to immunity request from other carriersMaintain chain of custody documents, judgements, and restitution orders within our databasesRespond to and calculate requests for restitution, record and coordinate restitution payments with accounting and update database records.
Identify, contribute, and participate in the organizing anti-fraud awareness events, including the creation of in-house presentationsDevelops and maintains industry, federal, state, and local government contacts involved in fraud investigation, detection, and preventionAttend monthly and quarterly meetings and keep management informed of developments that may impact claim results in specific regionsParticipate in discussion and increase industry awarenessMaintain and pursue technical competency relating to fraud awareness and education through insurance fraud seminars and other company sponsored courses at the direction of special investigations unit leadershipUnderstanding of statutes and laws that impact the siu community and as it relates to investigations.
Required education and experience:
Knowledge of insurance claims process and or investigation of insurance schemes
1-3 year within insurance operation roles such as claims
2-5 years with a formal analytical role (data analyst, statistician)
Proficiency with excel, word, and power point
Knowledge of statistical, time series and link analysis
Bilingual (english/spanish) a plus
Reasonable knowledge of evidence gathering techniques
Preferred qualifications:
Strong analytical skills
Self-motivated
Strong organization and time management skills
Strong written and verbal skills
Technical skills
The ability to accurately maintain data and records
Proven ability to acquire, analyze and interpret information from various sources and formulate theories regarding trends and patterns required.
Proficiency with microsoft office suite particularly excel/powerpoint/teams, canva & share point
The ability to perform internet research
Knowledge of related analytical and statistical techniques
Hiring insights
Job activity
Posted 1 day ago
