Start Date
Immediate
Expiry Date
08 Dec, 25
Salary
77120.0
Posted On
09 Sep, 25
Experience
2 year(s) or above
Remote Job
Yes
Telecommute
Yes
Sponsor Visa
No
Skills
Good communication skills
Industry
Insurance
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated SIU Consultant (Intermediate Level), you will within defined guidelines and framework, provide specialized identification, investigative, analytical, and advisory services, particularly when claim or underwriting fraud is suspected. Use various analytical and digital fraud detection tools and resources to evaluate SIU referrals and identify potential fraud within claims or policies. Monitor and identify fraud trends through ongoing analysis and shares findings with core SIU teams.
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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.