SIU Case Manager
USAA
full-time
Posted on:
Location Type: Hybrid
Location: Col Springs Metro • Arizona, Colorado • 🇺🇸 United States
Visit company websiteSalary
💰 $85,040 - $162,550 per year
Job Level
Mid-LevelSenior
About the role
- Reviews investigative findings of claims identified as having confirmed elements of fraud, concealment, misrepresentation, or intentional act by evaluating the evidence to determine transfer or appropriation of claims disposition.
- Communicates results of review to members, claimants, Departments of Insurance, and law enforcement as applicable.
- Leads, guides, and directs investigative activities such as additional contacts, statements, etc. to take appropriate action for identified claims.
- May complete investigative leads, contacting local law enforcement, fire departments, etc. to gather additional information as needed.
- Serves as the adjuster of record on transferred claims.
- Applies knowledge of regulatory requirements necessary to act on claims.
- Assists with developing and implementing proactive investigative strategies, training, and communications.
- Writes complex coverage and denial letters in compliance with policy and regulatory requirements.
- Facilitates fraud prevention training.
- Serves as a mentor and SME, responsible for training team members.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
Requirements
- High School Diploma OR General Equivalency Diploma
- 4 years of P&C SIU experience or adjusting complex claims experience
- Demonstrated understanding of auto and property insurance contracts, coverage application and insurance litigation process
- Successfully acquire Property & Casualty (P&C) adjuster license and state registrations within 90 days of hire
- Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud
- Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems
- Ability to write reports and document activities and decisions in a case management system
- Proficiency in understanding the legal aspects of SIU related files
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
- career path planning and continuing education
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
investigative findings reviewclaims disposition evaluationcoverage and denial letter writingevidence gatheringcase management documentationfraud prevention strategiesinsurance litigation processregulatory compliance knowledgerisk managementP&C adjusting
Soft skills
communicationleadershipmentoringorganizational skillsproblem-solvingprioritizationtrainingguidancecollaborationattention to detail
Certifications
Property & Casualty (P&C) adjuster license