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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Fraud Investigations and Insurance Claims Investigations, utilizing strong Analytical and Critical Thinking skills to evaluate complex claims and validate evidence. Proficient in Evidence Gathering, Documentation, and Problem Analysis to support decision-making in investigations.
Highest-signal resume keywords
Fraud InvestigationsInsurance Claims InvestigationsAnalytical ThinkingEvidence GatheringDecision Making
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Investigative SkillsDocumentationsProblem AnalysisTime ManagementInterviewing
Soft Skills
Critical Thinking
Tools & Technologies
SIU SystemsAnalytic Tools
Industry Keywords
InsuranceFraudClaimsInvestigationsNorthern California
About the role
Key responsibilities & impact- Enter SIU claim data into multiple SIU systems
- Review investigations with fraud outcomes to validate whether denial is appropriate
- Update files with investigation outcomes and return files to market claim offices when no fraud or insufficient evidence is found
- Conduct complex online data application searches, research, and evaluation
- Conduct complex site inspections at body shops, medical clinics, loss locations, and other sites
- Investigate potentially fraudulent claims, including scene investigations and surveillance as needed
- Validate information obtained through investigations and follow up on possible leads
- Summarize documents and enter claim system notes documenting evaluations and decision-making
- Use analytic tools and SIU field intelligence to identify complex claims and support evidence of fraud and damages
- Research and respond to complex customer communications, concerns, conflicts, or issues
- Service the broader Northern California region as part of the SIU Fraud Investigation Department
Requirements
What you’ll need- Preferred candidate based in or around San Francisco, Oakland, San Jose, Sacramento, or surrounding commuting areas
- Strong background in investigations and insurance
- Analytical Thinking
- Critical Thinking
- Decision Making
- Documentations
- Evidence Gathering
- Fraud Investigations
- Insurance Claims Investigations
- Interviewing
- Investigative Skills
- Problem Analysis
- Special Investigations
- Time Management
- Authorization to work in the United States
- Not eligible for work visa sponsorship
- Dedicated, private workspace free from distractions when working from home
- Appropriate desk and seating
- Reliable internet with minimum speeds of 50 MB download and 5 MB upload
Benefits
Comp & perks- Comprehensive technology setup including a laptop, monitors, headset, keyboard, and mouse
- Monthly connectivity reimbursement for employees eligible to work from home
- Dedicated, private workspace requirements for home working
- Reliable internet requirement with minimum speeds of 50 MB download and 5 MB upload
