SIU Investigator Job at Delta Group, Albany, NY

SzhVWTd3QzZsRzNsSnQyMm9HV1RLdzhtdkE9PQ==
  • Delta Group
  • Albany, NY

Job Description

Delta Group is a privately held, woman-owned, national investigative firm established in 1983 and headquartered in Buford, Georgia. With over 40 years of experience, Delta Group was built on the foundations of three key factors: People, Innovation and Results. People have always been at the core of who we are at Delta Group, and we pride ourselves on a culture that fosters the development and growth of our team. When it comes to Innovation, Delta Group has integrated innovation as a key driver in the development of our quality investigative performance and results across everything that we do. Throughout 4 decades in business, Delta Group has always been a results-driven company. We have a longstanding history of commitment to our clients in building trust based on our results and relationships. We've seen many changes during our tenure, but one thing that has never changed is our commitment to providing quality results.

The Special Investigation Unit of Delta Group investigates and identifies questionable and suspicious claims for our partners, communicating with claims personnel, insurance carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and deter fraud. The candidate should have extensive experience with claims for all lines of insurance, with a heavy emphasis on Workers' Compensation claims.

JOB DUTIES:
  • Conduct timely investigations including recorded statements and interviews of claimants, witnesses, and employers.
  • Provide timely status updates to case manager and client.
  • Timely and clear documentation of the claim files.
  • Maintain highest level of confidentiality and professionalism.
  • Develop appropriate investigative action plan.
  • Ensure accuracy, quality and timeliness of the evidence gathered during an investigation as well as compliance with all applicable laws, legal codes, and governing agencies.
  • Provide Claim Adjuster with timely investigation results and document investigative findings.
  • Determine whether additional evidence is required including but not limited to accident reports, accident scene reconstructions, witness statements, police reports, expert opinion, etc.
  • Provide recommendations and decisions surrounding investigative efforts.
  • Perform detailed database queries on SIU investigations to include analysis and organization of critical data to assist during the assigned investigation.
  • Be able to evaluate State compliance referrals, as applicable, when questionable or suspicious activity is identified.
  • Maintain active membership in professional organizations that provide SIU assistance and resources..
  • Establish and maintain relationships with law enforcement, government regulatory agencies and insurance industry personnel assisting when needed or required.
JOB REQUIREMENTS:
  • Strong investigative skills necessary.
  • Must be detail oriented.
  • Ability to recognize patterns of inconsistencies that may be linked to fraudulent activity.
  • Must have ability to interact with clients, repair shops and appraisers, and employers.
  • Ability to work independently.
  • Excellent verbal and written communication skills.
  • Good organization and time management skills.
  • Demonstrate knowledge of tools and techniques needed for conducting insurance claims investigations.
  • Demonstrate proficiencies with computer software, Word, Excel, Outlook and Teams.
  • Must have the ability to utilize an objective perspective when performing tasks.
EQUIPMENT NEEDED:
  • Laptop Computer
  • Cell Phone
  • Audio Recording device with download capability
  • Digital Camera
  • Tape measure
EDUCATIONAL REQUIREMENTS:
  • CFE or FCLS designations preferred
  • 5-10 years' experience in claims and SIU investigations preferred
Delta Group

Job Tags

Similar Jobs

Touchstone Communities

Certified Medication Aide Job at Touchstone Communities

 ...BANDERA NURSING & REHAB, BANDERA, TX Our community isseeking a compassionate and dedicated Certified Medication Aide to join our team!We look forward to welcoming you to our team and working together to make a positive impact on the lives of those we serve. The... 

CORT

Delivery Driver / Furniture Assembler Job at CORT

 ...Overview: CORT Furniture Rental is hiring immediately for full-time non-CDL drivers for our Nashville District ! The Delivery Driver works collaboratively as part of the Operations team. You will be responsible for loading furniture and delivering safely... 

Caramanda's Bake Shoppe

Baker Job at Caramanda's Bake Shoppe

 ...Our popular bakery, Caramandas Bake Shoppe, is looking for an experienced, full-time baker to join our team. Must love all things sweet: cakes, cupcakes, cookies, and working with a diverse group of people. Our ideal candidate is a self-starter, punctual, and hard-working... 

Fixins Soul Kitchen

Waiter Job at Fixins Soul Kitchen

Job Description We are seeking an experienced and passionate fine dining server to join our team and provide exceptional service to our discerning clientele. The ideal candidate will possess extensive knowledge of food and wine, impeccable presentation skills, and a...

Metro Community Health Center

CRNP Job at Metro Community Health Center

 ...life cycle Perform complete physical exams; obtain complete medical history and record findings; order appropriate laboratory and diagnostic...  ...procedures, providing patient instructions, and conducting in-office testing and procedures Supports the clinical team with...