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About the Role

Perform triage duties to review claims identified by our predictive fraud tool to determine if an SIU investigation is warranted. Within defined guidelines and framework, protect USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures.

Responsibilities

• Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third party claims.
• Participates in the development of fraud prevention strategies.
• Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures.
• Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
• Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
• Make recommendations within defined authority guidelines.
• Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
• Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention.
• May serve as a resource team member on specific matters through demonstrated skill or training.
• Assists with the delivery of fraud awareness training initiatives in a defined environment.
• Handles CAT duty responsibilities as business requires.
• Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

Requirements

• High School Diploma or General Equivalency Diploma (GED).
• 2+ years’ experience as an SIU Investigator investigating claims from multiple lines of business (auto/property).
• Fraud industry investigation experience.
• Experience obtaining statements from various parties to incidents, witnesses, and suspects.
• Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
• Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems.
• Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems.
• Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology.

Skills

• Experience in analyzing digital fraud tool indicators to determine investigation necessity and triage cases.
• 2+ years claims adjusting experience, OR 4+ years prior investigative law enforcement (to include military) or relevant US military experience gained through military service or gained as a military spouse / domestic partner.

Location

• Remote eligible in the continental U.S.
• Occasional business travel

Work Type

• Remote
• Hybrid

Experience Level

• 2+ years’ experience as an SIU Investigator
• 2+ years claims adjusting experience
• 4+ years prior investigative law enforcement (to include military) or relevant US military experience

Education Level

• High School Diploma or General Equivalency Diploma (GED)

Salary/Compensations

• $77,120 - $147,390

Benefits

• Comprehensive medical, dental and vision plans
• 401(k)
• Pension
• Life insurance
• Parental benefits
• Adoption assistance
• Paid time off program with paid holidays plus 16 paid volunteer hours
• Various wellness programs
• Career path planning
• Continuing education

About the Company

• USAA's mission is to empower its members to achieve financial security through highly competitive products, exceptional service and trusted advice.
• USAA seeks to be the #1 choice for the military community and their families.
• USAA core values: honesty, integrity, loyalty and service.
• USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.
• USAA does not provide visa sponsorship for this role.
• USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive.
• Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
• USAA is unlike any other financial services organization.
• The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community.
• USAA upholds the highest standards and ensures that its corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with its core values of service, loyalty, honesty and integrity.
• USAA attributes its long-standing success to its 35,000 employees.
• USAA is committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families.
• USAA serves more than 13 million members.

Equal Opportunity

• USAA is an Equal Opportunity Employer.
• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
• USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
• California applicants, please review our HR CCPA - Notice at Collection here.