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SIU Consultant
CNA Insurance. Investigate suspicious or potentially fraudulent activity across all lines of business .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in investigating suspected claim and provider fraud, developing investigation strategies, and maintaining detailed case records. Proficient in delivering fraud awareness training and presenting findings to stakeholders and outside agencies.
Highest-signal resume keywords
Investigation Of Claim FraudAnalysis And ReportingFraud Awareness TrainingKnowledge Of Insurance Fraud LawVendor Coordination
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Detailed InvestigationsCase Record MaintenanceInvestigation Strategy DevelopmentFraud Resolution RecommendationsTimely Reporting
Soft Skills
CollaborationCommunicationMentoring
Industry Keywords
Insurance FraudRegulatory ComplianceFraudulent Activity InvestigationClaim ProfessionalsStakeholder Engagement
About the role
Key responsibilities & impact- Investigate suspicious or potentially fraudulent activity across all lines of business
- Conduct detailed investigations of suspected claim and/or provider fraud
- Collaborate with insureds, claimants, witnesses, experts, claim professionals, counsel, and other stakeholders
- Develop and execute investigation strategies
- Manage investigation activities and coordinate or oversee vendor service partner activities in the field
- Maintain detailed case records and create comprehensive reports of investigative findings and conclusions
- Present findings and propose solutions for claim and/or provider resolution
- Analyze, summarize, and report key metrics
- Identify and participate in process or procedural improvements
- Develop and deliver fraud awareness or regulatory compliance training and mentor lower-level SIU staff
- Present suspected claim fraud cases to outside agencies and testify on behalf of the company
- Keep current on insurance fraud laws, regulations, trends, and emerging issues
- Participate in insurance fraud or related professional associations
Requirements
What you’ll need- Experience investigating suspected claim and/or provider fraud
- Ability to conduct detailed analysis and thorough, timely investigations
- Ability to develop and execute investigation strategies
- Ability to manage investigation activities independently with moderate direction
- Ability to coordinate and oversee vendor service partner activities in the field
- Ability to maintain detailed, accurate and timely case records and reports
- Ability to make recommendations for claim and/or provider resolution
- Knowledge of insurance fraud law, regulations, trends, and emerging issues
- Ability to develop and deliver fraud awareness or regulatory compliance training
- Ability to present suspected claim fraud cases and testify in civil or criminal matters
Benefits
Comp & perks- Comprehensive and competitive benefits package
- Benefits supporting employees’ and family members’ physical, financial, emotional and social wellbeing goals
- Reasonable accommodations for qualified individuals with disabilities in the recruitment process