Sr. Claims Examiner - SIU jobs in United States
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Philadelphia Insurance Companies · 4 hours ago

Sr. Claims Examiner - SIU

positionEwing, NJ
timeFull-time
remoteOnsite
senioritySenior Level

Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products. They are seeking a Sr. Claims Examiner - SIU to evaluate referred insurance claims for potential fraud, conduct thorough investigations, and collaborate with vendor partners and authorities in prosecuting insurance fraud cases.

Financial ServicesReal Estate
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Growth Opportunities

Responsibilities

Evaluate referred insurance claims for potential insurance fraud
Conduct thorough investigations of suspect insurance claims and policy applications
Conduct insurance fraud investigations in accordance with applicable law and determine whether suspect claims meet state reporting thresholds
Work with vendor partners to conduct relevant field investigations
Complete database investigations
Review and evaluation of claims and applications referred to the SIU for possible fraud
Conduct database investigations, including use of CLEAR, ISO and various search engines
Assignment to and coordination with third-party field investigators
Ensure third party field investigators conduct appropriate investigations
Review and evaluation of third-party investigator reports for thoroughness and accuracy
Review and evaluation of completed SIU investigations for referral to state authorities, law enforcement and/or the NICB
Work with state authorities, law enforcement and/or the NICB in prosecuting insurance fraud cases

Qualification

Insurance fraud investigationDatabase investigationsCLEARISOCoordination with investigatorsReviewing reportsCollaboration with law enforcement

Required

Evaluate referred insurance claims for potential insurance fraud
Conduct thorough investigations of suspect insurance claims and policy applications
Conduct insurance fraud investigations in accordance with applicable law
Determine whether suspect claims meet state reporting thresholds
Work with vendor partners to conduct relevant field investigations
Complete database investigations
Review and evaluation of claims and applications referred to the SIU for possible fraud
Conduct database investigations, including use of CLEAR, ISO and various search engines
Assignment to and coordination with third-party field investigators
Ensure third party field investigators conduct appropriate investigations
Review and evaluation of third-party investigator reports for thoroughness and accuracy
Review and evaluation of completed SIU investigations for referral to state authorities, law enforcement and/or the NICB
Work with state authorities, law enforcement and/or the NICB in prosecuting insurance fraud cases

Benefits

Tuition reimbursement
Generous 401K match
Volunteer Benefits
Paid Vacation
Medical Benefits
Educational Incentives
Family Friendly Benefits
Investment Incentives

Company

Philadelphia Insurance Companies

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Philadelphia Insurance Companies is a marketer and underwriter of commercial property, casualty, and liability insurance.
dateFounded in 1980
location
Bala Cynwyd, Pennsylvania, USA
people-size1001-5000 employees
web-link
https://www.phly.com

Funding

Current Stage
Late Stage

Leadership Team

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John Doyle
EVP & Chief Underwriting Officer
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Recent News

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Company data provided by crunchbase