SIU Specialist - Workers' Compensation

at  Berkshire Hathaway Direct Insurance Company

The Special Investigations Unit Specialist will be responsible for conducting insurance fraud investigations into all lines of P&C business including: Commercial Auto, Property, General Liability, Professional Liability, and Workers’ Compensation. The ideal candidate will have experience specifically in Workers’ Compensation fraud including investigation experience in claimant fraud, premium fraud, and provider fraud. Job duties will include the following:

• Conduct thorough SIU investigations from start to finish.
• Gather, analyze, and convey complex fraud matters into actionable strategies to identify, mitigate, and combat fraud.
• Provide detailed documentation and reports on investigative findings to adjusters, underwriters, management, and law enforcement.
• Utilize internal and external databases to conduct background checks to develop investigation and identify potential fraud ring involvement.
• Coordinate vendor assignments such as surveillance, social media, and background checks.
• Work in conjunction with Underwriting to develop best practices to mitigate fraud proactively identify application fraud and premium avoidance.
• Act as a liaison between Company and local/state/federal law enforcement, NICB, and other SIU.
• Submit Questionable Claim Referrals to NICB and respective DOIs.
• Testify in court proceedings on fraud matters, when required.
• Ongoing education and awareness of industry trends, investigative techniques, and technologies that aid in the investigation of insurance fraud.
• Conduct fraud training for various lines of business within the company.

Required Skills/Knowledge

• Must maintain strict confidentiality
• Knowledge of insurance claims and policies
• Strong analytical and problem solving skills
• Ability to recognize, interpret, and articulate trends and patterns from various data points
• Self motivated and able to work independently while meeting assigned deadlines
• Excellent verbal and written communication skills
• Ability to thrive in a remote environment

Experience and Education

• Minimum of 2+ years SIU experience (Workers’ Compensation claimant and premium fraud strongly preferred)
• Bachelor’s Degree
• CIFI, SCLA, and/or CFE Designations preferred

About biBERK:
biBERK is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBERK.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer.
BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBERK are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

Some highlights of our benefits are:

• Great work environment with growth opportunity
• Competitive compensation
• Generous amounts of vacation and sick time
• Closed on major holidays
• 401(k) with company match
• A fantastic healthcare package
• Tuition reimbursement after 6 months of employment

In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is $75-85k per year. Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law

• Conduct thorough SIU investigations from start to finish.
• Gather, analyze, and convey complex fraud matters into actionable strategies to identify, mitigate, and combat fraud.
• Provide detailed documentation and reports on investigative findings to adjusters, underwriters, management, and law enforcement.
• Utilize internal and external databases to conduct background checks to develop investigation and identify potential fraud ring involvement.
• Coordinate vendor assignments such as surveillance, social media, and background checks.
• Work in conjunction with Underwriting to develop best practices to mitigate fraud proactively identify application fraud and premium avoidance.
• Act as a liaison between Company and local/state/federal law enforcement, NICB, and other SIU.
• Submit Questionable Claim Referrals to NICB and respective DOIs.
• Testify in court proceedings on fraud matters, when required.
• Ongoing education and awareness of industry trends, investigative techniques, and technologies that aid in the investigation of insurance fraud.
• Conduct fraud training for various lines of business within the company