MCU Investigator (Finance)

JOB DESCRIPTION

This is a remote position - Uniondale, NY

Job Description:

Chubb is currently seeking a SIU Major Case Investigator to join our team working in the State of New York. This individual will be responsible for identifying and investigating complex organized fraud cases in partnership with our SIU Teams, claim, and legal partners.

Position Responsibilities:

In this role the SIU Major Case Investigator will form strong relationships with our Customers, and Claim Partners across all lines of business to help identify, detect and deter orchestrated fraud perpetrated by medical providers, attorneys, contractors, claimants etc. The SIU Major Case Investigator will be responsible for the following:

• Proactively initiate and manage a major case inventory of organized fraud participants.
• Conduct comprehensive investigations to develop thorough cases supported by evidence through statements, EUOs, depositions, clinic visits, background investigative findings, and data analysis.
• Identify and implement appropriate resolution strategies for investigations, which may include affirmative litigation, settlement, and/or claim workflow implementations.
• Collaborate and communicate with the Claim Department, Claim Operations, Loss Control Department, Underwriting Departments, Agents, Defense Counsel, Insureds, SIU Manager, Law Enforcement, Regulatory Agencies, and Industry Anti-Fraud Organizations.
• Establish strong business relationships and deliver exceptional customer service.
• Maintain and monitor an active diary, properly document all developments in claim files, prepare investigative reports, maintain a suspicious claim database, and prepare quarterly reports for SIU management.
• Be familiar with and adhere to all State fraud statutes.
• Manage investigation through all phases of litigation in conjunction with our legal partners.
• Actively pursue memberships in professional Anti-Fraud investigative organizations and participate in associated training and events.
• Develop and provide fraud awareness training to internal and external customers.

QUALIFICATIONS

Knowledge

ABOUT US

Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.