SIU Examiner at Bamboo Insurance

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Full Time

Start Date

Immediate

Expiry Date

10 Apr, 26

Salary

100000.0

Posted On

10 Jan, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Analytical Thinking, Effective Communication, Attention to Detail, Ethical Judgment

Industry

Insurance

Description

Job Details Position Type: Full Time Job Category: Claims Job Summary: A Special Investigations Unit (SIU) Examiner detects and prevents insurance fraud by thoroughly investigating suspicious claims, gathering evidence, interviewing witnesses, analyzing data, and collaborating with law enforcement to protect insurers from financial loss, ensuring compliance, and maintaining industry integrity. They develop investigative plans, recommend actions (like denial or referral), and maintain confidentiality while using skills in analysis, detail, and sometimes surveillance or digital forensics. Duties & Responsibilities: Fraud Evaluation: Review claims and applications referred by adjusters/advocates or automated systems to identify "red flags" and suspicious patterns. Investigation Management: Conduct thorough desk or field investigations, including background searches, scene inspections, and clinic audits. Evidence Gathering: Obtain recorded statements, interview witnesses/suspects, and analyze external records such as medical notes, financial data, and social media activity. Vendor Coordination: Assign cases to and oversee the work of third-party field investigators and surveillance teams, ensuring report accuracy. Reporting & Referral: Prepare detailed summaries for management and refer verified fraud cases to state authorities, law enforcement, or the National Insurance Crime Bureau (NICB). Legal Support: Provide expert testimony in legal proceedings and assist in the prosecution of fraud cases. Required Skills & Abilities: Analytical Thinking: Ability to digest complex information quickly to uncover fraudulent schemes. Effective Communication: Strong interpersonal skills for interviewing and drafting professional reports. Attention to Detail: Meticulous documentation to ensure investigations meet legal and regulatory standards. Ethical Judgment: Maintaining confidentiality and impartiality while navigating sensitive legal and compliance environments. Required Education & Experience: 10 years' experience in claims, law enforcement, or related investigative roles Minimum of 4 years' SIU experience in claims, law enforcement, or related investigative roles Bachelor's degree in a relevant field like criminal justice or related practical experience CFE (Certified Fraud Examiner) or CIFI (Certified Insurance Fraud Investigator). Preferred Requirements: Previous SIU experience for Homeowners insurance carriers or equivalent vendor Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Travel multiple times a year to in-person staffing meeting Salary: Starting at $100,000 annually. Candidate's skills, experience and abilities will be taken into consideration for final offer Bamboo is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations.

Responsibilities

The SIU Examiner detects and prevents insurance fraud by investigating suspicious claims and gathering evidence. They collaborate with law enforcement and prepare detailed reports for management.