United Automobile Insurance Company (UAIC) seeks an experienced SIU Investigator for its Headquarter Office.
For information on UAIC, please visit: www.uaig.net
What you ll be doing:
- Conduct in-depth research and review of suspected fraudulent or abusive patterns to develop sufficient evidence to conclusively establish facts involving insured s, claimants, medical and auto body shop providers, or other entities.
- Conduct Clinic Inspections.
- Conduct Examinations Under Oath.
- Knowledge of Current Procedural Terminology.
- Collect, utilize and interpret data obtained from a variety of computer generated reports and other sources; thereby identifying and documenting questionable patterns related to medical modalities, procedures, and other practices which merit further investigation.
- Maintain assigned investigation files, document evidence, and prepare comprehensive investigation reports at the completion of each investigation.
- Assist in conducting comprehensive interviews: medical and other providers aforementioned, insured s/claimants in the presence of their attorneys where applicable, and witnesses to obtain statements and information admissible under accepted rules of evidence in civil and criminal court proceedings.
- Conduct special projects initiatives/investigations referred by the House Counsel.
- Establish and maintain liaison with NICB, law enforcement officers and others to obtain assistance in conducting, facilitating and enhancing investigations.
- Knowledgeable about all applicable State of Florida insurance regulations, especially PIP regulations to ensure duties and assignments are carried out within the requirements of applicable law and office expectations
WHAT YOU LL NEED:
- Candidates must have 5 years of industry experience.
- Bilingual English-Spanish preferred.
- Strong critical thinking and analytical skills.
- Intermediate skill level in MS Word, Excel and Outlook.
- Knowledgeable of applicable fraud statutes.
- High degree of integrity as demonstrated by:
- Appropriate treatment of confidential information.
- Adherence to policies, rules and regulations.
- Professional conduct dealing with persons internal and external to the organization.
- Expert knowledge of medical claims processing and investigations a strong plus.
- Experience in CPT codes and medical terminology highly preferred.
Interviewing skills: Analytical skills and ability to make deductions; logical and sequential thinker, computer literate; database and Internet proficient. Has knowledge of available resources (internal and external) to assist in investigations
Full-time UAIC team members are offered a comprehensive Total Rewards Program, including:
401(k) Retirement Savings Plan
Comprehensive Medical, Prescription Drug, Vision and Dental Insurance
Paid Time Off, Holidays and Leave programs
Flexible spending accounts
Business casual dress
Basic Life Insurance and Voluntary Life/ADD
Short Term and Long Term Disability
United Automobile Insurance is an Equal Opportunity employer.
Associated topics: crime scene, detective, fingerprint, inspector, investigate, investigation, investigative, investigator