SIU Investigator - Buffalo, NY

Delta Group is a privately held, woman-owned, national investigative firm established in 1983 and headquartered in Buford, Georgia. With over 40 years of experience, Delta Group was built on the foundations of three key factors: People, Innovation and Results. People have always been at the core of who we are at Delta Group, and we pride ourselves on a culture that fosters the development and growth of our team. When it comes to Innovation, Delta Group has integrated innovation as a key driver in the development of our quality investigative performance and results across everything that we do. Throughout 4 decades in business, Delta Group has always been a results-driven company. We have a longstanding history of commitment to our clients in building trust based on our results and relationships. We’ve seen many changes during our tenure, but one thing that has never changed is our commitment to providing quality results.

The Special Investigation Unit of Delta Group investigates and identifies questionable and suspicious claims for our partners, communicating with claims personnel, insurance carrier SIU staff, law enforcement, and government regulatory agencies to identify, prevent and deter fraud. The candidate should have extensive experience with claims for all lines of insurance, with a heavy emphasis on Workers’ Compensation claims. 

JOB DUTIES:

Conduct timely investigations including recorded statements and interviews of claimants, witnesses, and employers.

Provide timely status updates to case manager and client.

Timely and clear documentation of the claim files.

Maintain highest level of confidentiality and professionalism.

Develop appropriate investigative action plan.

Ensure accuracy, quality and timeliness of the evidence gathered during an investigation as well as compliance with all applicable laws, legal codes, and governing agencies.

Provide Claim Adjuster with timely investigation results and document investigative findings.

Determine whether additional evidence is required including but not limited to accident reports, accident scene reconstructions, witness statements, police reports, expert opinion, etc.

Provide recommendations and decisions surrounding investigative efforts.

Perform detailed database queries on SIU investigations to include analysis and organization of critical data to assist during the assigned investigation.

Be able to evaluate State compliance referrals, as applicable, when questionable or suspicious activity is identified.

Maintain active membership in professional organizations that provide SIU assistance and resources..

Establish and maintain relationships with law enforcement, government regulatory agencies and insurance industry personnel assisting when needed or required.

JOB REQUIREMENTS:

Strong investigative skills necessary

Must be detail oriented

Ability to recognize patterns of inconsistencies that may be linked to fraudulent activity

Must have ability to interact with clients, repair shops and appraisers, and employers.

Ability to work independently

Excellent verbal and written communication skills

Good organization and time management skills

Demonstrate knowledge of tools and techniques needed for conducting insurance claims investigations

Demonstrate proficiencies with computer software, Word, Excel, Outlook and Teams

EQUIPMENT NEEDED:

Laptop Computer

Cell Phone

Audio Recording device with download capability

Digital Camera

Tape measure

EDUCATIONAL REQUIREMENTS:

CFE or FCLS designations preferred

5-10 years’ experience in claims and SIU investigations preferred

The final job level and annual salary will be determined based on the education, qualification, knowledge, skills, ability, and experience of the final candidate(s), and calibrated against relevant market data and internal team equity.

Delta Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex (including pregnancy, sexual orientation, gender identity / expression), national origin or ancestry, genetic information (including family medical history), physical or mental disability, protected veteran status, or any other characteristic protected under federal, state or local law, where applicable, and those with criminal histories will be considered in a manner consistent with applicable state and local laws.