This position works in the office M-F in Auburn Hills, MI.

PRIMARY PURPOSE To independently conduct insurance defense investigations to include recorded statements, accident scene Investigations, AOE/COE investigations as assigned; to identify red flag indicators and evidence that support the objectives of the investigation; to document findings in detailed, professional investigative reports and make recommendations as appropriate.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Conducts field investigation assignments as requested by examiners, clients or assigned legal counsel including recorded statements, scene investigations, AOE/COE investigations and/or other specialized field efforts to establish whether the alleged injury was work-related and happened in the course and scope of employment, or whether the injury was non-industrial or affected by third parties.
• Conducts thorough review of claim file, identifies witnesses and/or other involved persons who may possess information or knowledge pertaining to incident under investigation, obtains recorded statements from the injured subject, witnesses, supervisors, department personnel, coworkers and/or other involved parties. Independently concludes investigations and documents findings in a detailed, professional investigative report.
• Identifies, documents and communicates red flag indicators and makes recommendations as appropriate.
• Maintains proper documentation of all relevant facts and evidence pertaining to the case in the appropriate claim handling system(s) and ensures investigations are completed according to service expectations and SIU best practices.
• Maintains technical competency and adherence with all applicable legal codes and statutes to ensure all investigations are conducted in a legal and ethical manner. Complies with deposition and courtroom testimony appearances as required.
• Conducts training for new team members as requested.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Travel as required.

QUALIFICATIONS

Education & Licensing
Bachelor’s degree from an accredited college or university preferred. Appropriate jurisdictional licensing as required. Fraud Claim Law Specialist (FCLS), Legal Principles Program (LPCS), Fraud Claim Law Associate (FCLA), and/or Senior Claim Law Associate (SCLA) preferred.

Experience

Three (3) years of claims industry, private investigation and insurance fraud experience, law enforcement or equivalent combination of education and experience required.

Skills & Knowledge

• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong investigative skills
• Strong organizational skills
• Excellent interpersonal skills
• Good judgment and discretion skills
• Ability to manage multiple assignments and set priorities
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

PhysicalComputer keyboarding, travel as required

Auditory/VisualHearing, vision and talking

NOTE Credit security clearance, current and valid driver’s license, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.