USAA · 2 months ago
SIU Consultant mid-level
United States
Full-time
Remote
Entry, Mid Level
$77K/yr - $147K/yr
2+ years expUSAA is dedicated to empowering members to achieve financial security through exceptional service and trusted advice. As a SIU Consultant, you will provide specialized investigative and analytical services to identify potential fraud within claims or policies, utilizing various analytical tools and resources.
Financial Services
No H1B
Responsibilities
Reviews data such as claims or policy files, medical bills, vendor billing, damage estimates, accident details, industry trends and environmental circumstances to identify potential fraud
Proactively identify and mitigate fraud risk through evaluation of digital and manual referrals, data sets, industry knowledge, publications, analysis of risk environment and assessment of USAA process and policies
Monitor and report on the performance of revised manual and digital fraud detection process
Utilize specialized software and tools to proactively identify suspicious patterns and trends of organized insurance fraud
Leverage referral data from manual and digital fraud detection to develop and provide recommendations to improve fraud identification effectiveness for internal teams and external partners
Develop and maintain relationships with stakeholders with internal and external stakeholders, leveraging expertise from law enforcement, NICB, and/or similar agencies to conduct impactful analysis and support operational success
Perform trend and link analysis in support of claim and policy fraud investigations and to identify potential opportunity in unidentified risks to the organization
Provide awareness training to SIU investigators regarding analytical tools and resources available in support of investigations
Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures
Qualification
Required
High School Diploma or General Equivalency Diploma
2 years of Property & Casualty fraud related investigative experience OR proven/documented experience conducting research using data and analytics, analyzing investigative evidence, and creating a case assessment report
Demonstrated investigatory or analytical skills with experience understanding fraud schemes
Experience analyzing data and identifying patterns within Property & Casualty claims or policies
Comprehensive understanding of industry accepted red flag indicators of insurance fraud
Ability to gather broad range of evidence and conduct in depth background analysis
Ability to handle sensitive and confidential information
Strong verbal, written, and interpersonal communication skill
Preferred
Strong analytical skills to include ability to write SQL, Python and leverage analytical databases such as snowflake, Alteryx, etc
2+ years of SIU or related insurance claim/policy investigative experience, basic understanding of SIU red flags
Experience using digital fraud detection tools for analysis, to include digital fraud detection performance, outliers and development of new fraud detection rules
Ability to work individually in a fast paced environment and process large quantity of alerts/referrals with a high level of quality and accuracy in decision making
Bachelor's degree or equivalent experience considered
Excellent written and verbal communication skills, including presentation experience
Benefits
Comprehensive medical, dental and vision plans
401(k)
Pension
Life insurance
Parental benefits
Adoption assistance
Paid time off program with paid holidays plus 16 paid volunteer hours
Various wellness programs
Company
USAA
At USAA, our mission is more than just words – it’s the reason we do what we do.
10001+ employees
Funding
Current Stage
Late StageCompany data provided by crunchbase