USAA

Consultant

• Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims
• Participates in the development of fraud prevention strategies
• Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures
• Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims
• Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools
• Makes recommendations within defined authority guidelines
• Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome
• Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention
• May serve as a resource team member on specific matters through demonstrated skill or training
• Assists with the delivery of fraud awareness training initiatives in a defined environment
• Handles CAT duty responsibilities as business requires
• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures

SIU Consultant, P&C – Mid-Level