Claims Representative, SIU

 

The SIU Investigator is responsible for the accurate detection and in-depth investigation of potentially fraudulent insurance activity, ranging from complex medical and staged accident claims and auto property matters to simpler application fraud issues. Investigative activities will include in-person interviews and recorded statements. Prepares and presents reports of impartial results to management for decision-making. Performs field work and coordinates efforts with industry fraud units, claim personal, counsel, law enforcement and agencies. May provide evidence and testimony in cases where law enforcement agencies pursue prosecution. May conduct fraud awareness training and/or investigate research. The individual will work in the field and be provided a company issued computer, phone and vehicle. 

 

This position is expected to primarily support portions of Central and South New Jersey, as well as Eastern Pennsylvania, and may also include responsibility for additional territories.  

 

RESPONSIBILITIES

• Prioritize and handle multiple tasks simultaneously. Adjust to fluctuating workload.
• Good File analyses/decision making when reviewing file documentation.
• Maintain diary to meet requirements for status reports on all investigations.
• Successfully completes investigation addressing all referral issues.
• Will attend a minimum of three days of formal training a year.
• Will participate in conducting fraud awareness training to company associates.
• Network with law enforcement and other investigators within the SIU Industry.
• Adhere to privacy guidelines.
• Cover large geographic areas.
• Complete accurate monthly reports and submit to supervisor timely

 

QUALIFICATIONS

• Prior P&C SIU experience preferred
• Individual must have one of the following:
• Bachelor’s Degree in Criminal Justice or
• An Associate’s Degree plus a minimum of two years experience with insurance related employment.
• A minimum of five years of experience within the insurance industry.
• A minimum of five years of law enforcement experience.
• Valid New Jersey Driver’s License
• Strong Computer Skills (Microsoft Excel, Word, Access and Outlook)
• Strong verbal and writing skills
• Working knowledge of Home and Auto Policies
• Bi-lingual in Spanish would be preferred, but not necessary
• Knowledge of big data (link analysis, predictive modeling tools etc... not mandatory but preferred).
• Knowledge of medical terminology and treatment plans

 

SALARY RANGE

The pay range for this position is $70,000 to $103,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.​

 

PERKS & BENEFITS

• 4 weeks accrued paid time off, 8 paid national holidays per year, and 2 floating holidays
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• Free onsite gym and health center at our Woodbridge Location
• Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
• Robust health and wellness program and fitness reimbursements
• Various Paid Family leave options including Paid Parental Leave
• Tuition Reimbursement 

 

ABOUT THE COMPANY

The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner’s insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.