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.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

• Ability to work independently with minimal supervision and manage a high volume of assignments in an expansive territory.
• High degree of knowledge and skills related to the investigation and defense of property claims.
• Strong knowledge of insurance principles, laws, and regulations pertaining to property and casualty insurance.
• Advanced knowledge of interview and evidence gathering techniques.
• Advanced knowledge of investigative methods to evaluate and apply property insurance laws, rules, regulations, and policies.
• Ability to work independently with minimal supervision and manage a high volume of assignments in an expansive territory.
• Strong verbal and written communication skills; Strong presentation skills and and ability to convey highly technical information and long-term projects.
• Strong organizational and time management skills/Self Motivated; ability to manage highly technical and long-range projects
• Proficient skills in Microsoft Office (Word and Outlook; highly skilled in Excel).
• Advanced investigative skills (Ability to conduct interviews on highly complex insurance, financial matters).
• Valid Florida driver’s license and ability to operate company owned/rented vehicles according to Citizen’s policy on vehicle use.
• Strong analytical and quantitative skills and ability to identify and analyze complex patterns.
• Strong customer service skills and ability to build relationships and collaborate effectively with internal and external stakeholders.

REQUIRED EDUCATION AND EXPERIENCE:

High School Diploma/GED.

Bachelor’s degree in field relevant to position related field OR 4 years of relevant experience OR a combination of college education and relevant work experience equivalent to 4 years.

AND

Six (6) or more years combined professional claims experience in property/casualty,

SIU/ Investigative experience.

PREFERRED QUALIFICATIONS:

• Seven (7) or more years combined professional claims experience in property/casualty, SIU / Investigative experience.

• Three (3) years of experience handling large property losses and/or agency investigations.

• Knowledge in policy language and residential construction.

• CIFI (Certified Insurance Fraud Investigator), FCLA (Fraud Claims Law Associate), and FCLS, (Fraud Claims Law Specialist).

• Previous investigative experience using a global approach to research organized activity, which includes multiple business entities and/or individuals.

• Bilingual (English/Spanish).

PHYSICAL REQUIREMENTS:

This position requires the ability to conduct field work on a regular basis and be able to work a flexible schedule. Ability to sit for long periods of time, hear and converse over the telephone, and key frequently on a computer for long periods of time (4 or more hours per day). Position also requires the ability to be mobile, operate a motor vehicle, inspect physical damage and work in a highly energetic and flexible work environment. Position also requires ability to travel overnight on a limited basis.

VISA sponsorship is not available for this position.

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