41 Complex Claims Consultant Healthcare jobs in Los Angeles

SIU Investigator

Overview

Company Overview:

Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you’re ready to grow with the best, explore a career with us and make a difference.

Job Description

Allied Universal® is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that suggest fraudulent behavior In relation to an Insurance claim. The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution.

• Auto Allowance and Company Credit Card for fuel and travel!
• Mustpossessa valid driver's license with at least one year of driving experience
• Pay Rate: $30 - $38/hr

RESPONSIBILITIES:

• Independently investigate suspected fraudulent insurance claims for a variety of coverage to include workers’ compensation, general liability, property and casualty and disability
• Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance
• Create and maintain detailed documentation for investigations, file reviews, audits, training tasks, consulting projects, and other assignments as directed
• Produce professional and expert reports, memos, and letters that are clear, concise, and grammatically correct
• Run appropriate database indices if necessary and verify the accuracy of results found
• Independently develop a strategic plan to achieve assignment objectives, ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor

QUALIFICATIONS (MUST HAVE):

• Must possess one or more of the following:
• • Bachelor’s degree in Criminal Justice
  • High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud
• Ability to be properly licensed as a Private Investigator as required by the state where work Is completed
• Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
• Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims
• Proficient understanding and application of anti-fraud laws, insurance regulations, and compliance standards within their home state and designated regional area.
• Proficient in utilizing laptop computers and cell phones.
• Special Investigative Unit (SIU) Compliance knowledge
• Ability to type 40+ words per minute with minimum error
• Flexibility to work varied and irregular hours and days including weekends and holidays

PREFERRED QUALIFICATIONS (NICE TO HAVE):

• Military experience
• Law enforcement
• Insurance administration experience
• Familiarity with California SIU regulations
• One or more of the following professional industry certifications:
• • Certified Fraud Investigator (CFE)
  • Certified Insurance Fraud Investigator (CIFI)
  • Fraud Claim Law Associate (FCLA)
  • Fraud Claim Law Specialist (FCLS)
  • Certified Protection Professional (CPP)
  • Associate in Claims (AIC)
  • Chartered Property Casualty Underwriter (CPCU)

BENEFITS:

• Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance
• Seven paid holidays annually, sick days available where required by law
• Vacation time offered at an initial accrual rate of 3.08 hours biweekly; unused vacation is only paid out where required by law

Closing

Allied Universal® is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com

If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.

Requisition ID

2026-1643341