SIU Investigator San Jose, CA

Delta Group is a privately held national investigative firm established in 1983 and headquartered in Buford Georgia. As pioneers of unmanned surveillance technology Delta Groups eRemote technology is an industry recognized product that continues to evolve and produce game-changing results. With more than 500 direct employees nationwide our domestic footprint is large enough to matter and small enough to care.

We pride ourselves on developing and retaining professional staff while maintaining diversity within our team.Our executive leadership team brings over 100 years of combined experience leading national carrier fraud divisions state fraud prosecutorial offices claims and program management divisions and investigative operations.

For over 41 years our investigative resources have helped organizations reduce risk improve profitability and increase revenue within the insurance industry. Our expert employees are located throughout the United States executing investigations for all types of claims including but not limited to workers compensation liability auto property disability and corporate investigations regardless of size. Come join our talented team and our commitment to people innovation and results.

The Special Investigation Unit of Delta Group investigates and identifies questionable and suspicious claims for our partners communicating with claims personnel insurance carrier SIU staff law enforcement and government regulatory agencies to identify prevent and deter fraud. The candidate should have extensive experience with claims for all lines of insurance with a heavy emphasis on Workers Compensation claims.

JOB DUTIES:

• Conduct timely investigations including recorded statements and interviews of claimants witnesses and employers.
• Provide timely status updates to case manager and client.
• Timely and clear documentation of the claim files.
• Maintain highest level of confidentiality and professionalism.
• Develop appropriate investigative action plan.
• Ensure accuracy quality and timeliness of the evidence gathered during an investigation as well as compliance with all applicable laws legal codes and governing agencies.
• Provide Claim Adjuster with timely investigation results and document investigative findings.
• Determine whether additional evidence is required including but not limited to accident reports accident scene reconstructions witness statements police reports expert opinion etc.
• Provide recommendations and decisions surrounding investigative efforts.
• Perform detailed database queries on SIU investigations to include analysis and organization of critical data to assist during the assigned investigation.
• Be able to evaluate State compliance referrals as applicable when questionable or suspicious activity is identified.
• Maintain active membership in professional organizations that provide SIU assistance and resources..
• Establish and maintain relationships with law enforcement government regulatory agencies and insurance industry personnel assisting when needed or required.

JOB REQUIREMENTS:

• Strong investigative skills necessary
• Must be detail oriented
• Ability to recognize patterns of inconsistencies that may be linked to fraudulent activity
• Must have ability to interact with clients repair shops and appraisers and employers.
• Ability to work independently
• Excellent verbal and written communication skills
• Good organization and time management skills
• Demonstrate knowledge of tools and techniques needed for conducting insurance claims investigations
• Demonstrate proficiencies with computer software Word Excel Outlook and Teams

EQUIPMENT NEEDED:

• Laptop Computer
• Cell Phone
• Audio Recording device with download capability
• Digital Camera
• Tape measure

EDUCATIONAL REQUIREMENTS:

• CFE or FCLS designations preferred
• 5-10 years experience in claims and SIU investigations preferred
  

The final job level and annual salary will be determined based on the education qualification knowledge skills ability and experience of the final candidate(s) and calibrated against relevant market data and internal team equity.

Delta Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color age religion sex (including pregnancy sexual orientation gender identity / expression) national origin or ancestry genetic information (including family medical history) physical or mental disability protected veteran status or any other characteristic protected under federal state or local law where applicable and those with criminal histories will be considered in a manner consistent with applicable state and local laws.

Required Experience:

Manager