SIU Claims Coordinator

At Coaction were a unique mix of leaders achievers thinkers and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.

Position Summary:

The SIU Claims Specialist is responsible for leading the companys Special Investigations Unit working with the Coaction approved investigation panel overseeing the detection investigation and prevention of fraudulent insurance claims across all lines of business. This role ensures compliance with state and regulatory reporting requirements drives investigative best practices and partners closely with claims leadership underwriting and legal teams to mitigate fraud risk and protect company assets.

Key Responsibilities:

• Manage workflow case assignments and performance metrics to ensure timely and effective investigations.

• Establish and maintain investigative standards protocols and quality controls.

• Oversee the identification of suspicious claims through analytics adjuster referrals and external intelligence.

• Direct and support complex or high-exposure investigations.

• Where appropriate coordinate field investigations interviews scene inspections surveillance background and social media investigations and evidence collection.

• Ensure proper documentation and investigative reporting to support claim decisions and potential litigation.

• Maintain full compliance with all state SIU regulations reporting requirements and fraud registry submissions.

• Serve as the primary contact for state fraud departments law enforcement and regulatory agencies.

• Assist in preparing and submitting mandated annual SIU plans training documentation and statistical reports.

• Partner with Claims leadership to identify fraud trends and provide recommendations for process improvements.

• Work with Underwriting to communicate emerging fraud patterns risk indicators and underwriting controls.

• Support the Legal department in cases progressing to litigation or criminal prosecution.

• Coordinate and/or deliver fraud awareness training to adjusters examiners and other business units.

• Utilize data analytics tools to identify fraudulent patterns emerging schemes and abuse trends.

• Develop dashboards reports and KPIs to measure unit effectiveness and program impact.

• Present fraud insights and trends to executive leadership.

• Manage relationships with external investigative vendors surveillance firms forensic experts and law enforcement.

• Evaluate vendor performance and ensure cost-effective use of external resources.

Qualifications:

• Bachelors degree in criminal justice Business Risk Management or related field preferred.

• 3 years of insurance claims or investigative experience

• Prior Law Enforcement SIU or Insurance Fraud experience strongly preferred.

• Professional certifications such as CIFI CFI CFE FCLS or PCI is highly desirable.

**This is not a fully remote position. Applicants must sit in our Morristown NJ office on our hybrid work schedule.**

Salary range specific to for this role : $60000-$90000 discretionary incentive bonus benefits depends on various factors including without limitation individual and organizational performance. The offered rate of compensation will be based on individual education experience and addition employees are eligible for standard benefits package including paid time off medical dental and retirement.

Equal Opportunity Employer

Coaction is an Equal Employment Opportunity employer. Coactions policy is not to discriminate against any applicant or employee based on race color religion national origin gender age sexual orientation gender identity or expression marital status mental or physical disability and genetic information or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.

If your application is selected you will receive an email directly from the Coaction Recruiting Team at asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.