Workers’ Compensation Insurance Fraud Investigator

Company Overview: The founders of P2i have a longstanding reputation as SIU and claim mitigation experts in CA for over 10 years. We offer industry leading salaries, a flexible work schedule and remote positions.  Our belief is that “you never work a day in your life when you are passionate about what you do.”  Employees receive on the job continuous training/education and are recognized for the successful outcomes of investigations.

Position Summary:

The SIU Analyst reviews all types of suspicious insurance claims (workers’ compensation, property & casualty and general liability) and makes determinations from an SIU and claim mitigation standpoint.  The SIU Analyst analyzes and synthesizes investigative reports, surveillance, records, claim files, medical documents/reports, legal documents and other pertinent information into a report with strategic recommendations and possible fraud referral filings.  This position requires the ability to read voluminous records, analyze and synthesize complex data into professional reports. This position involves strategic consulting and communication with adjusters, employers, defense attorneys and law enforcement.  This position requires the ability to maintain confidentiality, work with integrity, think outside the box and obtain information to assist investigative efforts. The SIU Analyst packages claims for law enforcement and coordinates cases through to potential filing of charges and prosecutions, coordinating trials and testifies as needed.  This position manages anywhere from 20-70 claims on an on-going basis for several months to several years. Our clients include self-insureds and third-party administrators.

• Non-Exempt
• Flexible Remote Schedule (M-F)
• Compensation: DOE

Qualifications

• Bachelor’s Degree
• Advanced reading comprehension and writing ability
• Demonstrated ability to review copious amounts of data and synthesize into a report
• Intermediate to advanced knowledge of Microsoft Office applications
• Highly organized and detail oriented with demonstrated ability to prioritize/multi-task in a fast- paced environment
• Ability to work with adjusters, employers, attorneys, law enforcement and physicians/nurses.
• Must be able to work collaboratively in a team environment with minimal supervision
• Strong analytical, problem-solving and time management skills
• Ability to exercise independent judgment and employ strong reasoning verbal and written skills

Desired Experience

• Report and/or grant writing experience
• Experience analyzing legal documents or medical reports
• Para-legal experience or experience working in a law firm
• Insurance or investigative experience
• Medical experience or knowledge of medical terms
• Case Management

To apply, please submit resume and cover letter to: hr@p2iservices.com