Special Investigations Unit (SIU) Consultant - Senior (P&C) at USAA

San Antonio, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

01 Feb, 26

Salary

162550.0

Posted On

03 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Fraud Investigation, Data Analysis, Analytical Skills, SQL, Python, Forensic Tools, Artificial Intelligence, Case Management, Problem Solving, Communication, Mentorship, Risk Assessment, Insurance Fraud, Stakeholder Engagement, Trend Analysis, Technical Competence

Industry

Financial Services

Description

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 We are looking for two Special Investigations Unit (SIU) Consultant Seniors. Depending on how you answer the questions below will help determine which position you may be a better fit, since there are some differences. Within defined guidelines and framework, provides specialized identification, investigative, analytical, and advisory services, particularly when claim or underwriting fraud is suspected. Works with leadership to leverage large data sets, technology, and software resources to assess exposure of complex insurance fraud schemes and develop investigative strategies on any level of potential fraud or risk to the organization. Influences the creation of and monitors progress of long-term fraud detection and prevention programs. Assists and supports multi-claim investigation efforts regarding any potential risk to our business or related industry. This role is remote eligible in the continental U.S. with occasional business travel. What you'll do: 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. Supports investigations into complex fraud, supporting SIU teams at all levels. Proactively identifies and mitigates fraud risk through evaluation of data sets, industry knowledge, publications, analysis of risk environment and assessment of USAA process and policies. Develops and presents investigative reports to management and other insurance professionals to share industry data, claims trends, government, and legal updates, and educate holistically. Develops and maintains 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. Leverages trend and link analysis to uncover emerging threats and mitigate risks to the organization. Uses advanced technical competence of fraud investigation to improve case effectiveness and outcomes for all complexities. Proactively conducts strategic, tactical, and operational analysis to identify the extent of known and unknown potential fraud risks to the organization and industry. Employs multiple resources to strategically identify and develop industry related intelligence and report findings to appropriate internal and external stakeholders to the organization. Provides mentorship and fraud detection and analytical training to other members within SIU and other organizational stakeholders . Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have: High School Diploma OR General Equivalency Diploma. 4+ years of fraud related investigative experience OR proven/documented experience conducting research using data and analytics, analyzing investigative evidence, and creating a case assessment report. Deep understanding of complex fraud schemes. Expert knowledge and experience analyzing data and identifying patterns within Property & Casualty claims or policies. Proficient in multiple analytical programs or software used to conduct in-depth analysis of potential fraud trends. Expert understanding of industry accepted red flag indicators of insurance fraud, identity theft, synthetic identifies, and money laundering schemes. Ability to gather broad range of data and evidence from multiple sources and conduct in depth analysis Ability to summarize and present confidential case information to leadership. Demonstrated verbal, written, problem solving, and interpersonal communication skills. What sets you apart: Position #1 3+ years of experience in a Special Investigations Unit (SIU), with a strong focus on leveraging data analytics for fraud detection. Proven ability to develop and implement business rules for identifying and preventing fraudulent activity within data systems (e.g., Snowflake, Tableau, Alteryx). Proficiency in SQL and Python for data analysis, manipulation, and reporting. Demonstrated understanding of fraud "red flags" and how to translate them into effective analytical data points for detection. Experience in validating the performance of digital fraud detection systems using analytical tools and methodologies. Highly organized, articulate, and a self-starter with a proactive approach to problem-solving. US military experience through military service or a military spouse/domestic partner What sets you apart: Position #2 3+ years of experience in a Special Investigations Unit (SIU) or related investigative role. Demonstrated knowledge of forensic tools and their application in SIU investigations. Experience in validating the performance and effectiveness of business rules within digital fraud detection systems. Experience using Artificial Intelligence (AI) tools and techniques to enhance investigative capabilities. Proven experience in building and managing case management systems to streamline investigations. Highly organized, articulate, and a self-motivated individual with a proactive approach to problem-solving. US military experience through military service or a military spouse/domestic partner Compensation range: The salary range for this position is: $85,040 - $162,550. USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, F-1, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. If you are an existing USAA employee, please use the internal career site in OneSource to apply. Please do not type your first and last name in all caps. Find your purpose. Join our mission. USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity. USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself – you just need to share our passion for serving our more than 13 million members. USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law. California applicants, please review our HR CCPA - Notice at Collection here.

Responsibilities

The role involves providing specialized identification, investigative, analytical, and advisory services related to suspected claim or underwriting fraud. It includes reviewing data to identify potential fraud, supporting investigations, and developing investigative reports for management.