Senior SIU Investigator (Field - Broward/Miami Dade)

Company Description

Searching for a place to make your mark? Every great team depends on the individual contributions of its members – the skills, talents and the passion that each team member brings. At Citizens, we’re building a workforce of top achievers committed to our company’s mission and vision. Our company values the knowledge that comes from experienced and dedicated individuals with a variety of backgrounds, in or out of insurance.

Citizens' Mission is to serve the people of Florida as the state's insurer of last resort, and as an innovative thought leader focused on promoting a healthy property insurance market.

 At Citizens, we are a team of dedicated, service-minded professionals committed to our policyholders. Come achieve and maximize your potential with us!

Job Description

ABOUT SIU:

Financial responsibilities drive the Citizens’ Special Investigations Unit’s (SIU) commitment to finding ways to more quickly identify and more effectively fight insurance fraud. To do this, Citizens’ SIU is committed to building the strongest, most innovative and most talented investigative and analytical teams. This requires that we recruit high achievers who thrive in an environment that emphasizes individuality, respect, growth, and ownership, and where the best ideas—even if new or untried—are the ones that make it to the top. As a part of the Citizens’ SIU team, you will be recognized and rewarded for your talents and outstanding performance, dedication, and loyalty.

We are now seeking qualified candidates to serve as an Investigator to work on our Complex Field Investigations Team that will work remotely in Broward, Miami Dade and surrounding areas whose primary focus is conducting investigations involving suspicious property claims, including fire, non-weather water and storm-related claims. The ideal candidate has direct education and experience investigating suspicious claims and policies (or other transferable experience) and an ability to work autonomously carrying out investigations and reporting findings. Investigative staff travel frequently to conduct investigations and are provided with the necessary equipment for their home-based office and paid mileage for the business use of their personal automobile.

POSITION SUMMARY:

The positions primary purpose is to conduct highly complex and highly sensitive investigations involving suspicions of insurance fraud related to the submission of high exposure property claims and/or insurance policies within Citizens’ insurance organization.

ESSENTIAL FUNCTIONS:

• Models ethical behavior and execute job responsibilities in accordance with Citizens core values, ethics, and information protection policies
• Exercises independent judgment, initiative and decision making when performing in-depth investigations; plans, prioritizes and carries out investigative assignments and conducts and/or coordinates interviews, property inspections, and Examinations Under Oath (EUO) and other fact gathering methods as appropriate for the purpose of obtaining material evidence
• Uses insurance knowledge and highly technical skillsets to perform complex fact pattern and legal analysis; requiring the synthesis of multiple data sets pertaining to investigative matters and completes all aspects of case management tracking, including preparation of case file notes, reports, graphs, tables, and documentation management in support of investigative findings.
• Self-directs the review of claims and/or underwriting user and system generated SIU referrals and other internal reports as assigned and in accordance with Citizens’ SIU policy and conducts moderately complex forensic research involving multiple external systems to determine the need for additional fact gathering and record collection prior to assignment by management.
• Prepares and refers claims and other matters involving suspicious insurance acts to the fraud bureau or other law enforcement/regulatory entity in accordance with Citizens’ policy and Florida statutes; prepares file presentations as well as responds to law enforcement file/information requests and represents Citizens at SIU industry meetings facilitated by law enforcement and NICB.
• Participates in the research, creation, and delivery of fraud awareness training to Citizens’ employees, business partners and other stakeholders as necessary to facilitate the identification and referral of potentially fraudulent insurance acts to SIU.
• May coach, counsel, or train less experienced staff, may also direct the work of others, may provide input in the development of best practices, performance management, goal setting and review process. 

Qualifications

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES: 

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