Claims Special Investigation Coordinator

At Coaction, we're a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.

Claims Examiner, Special Investigation

As the Claims Special Investigation Coordinator you will need to be creative and embrace change in this fast paced and growing environment. Experience with red flag indicators, potential fraud identification, and multiple Special Investigation methods (social media searches, surveillance, background checks) is critical for this role. This position is also responsible for administration of invoices and managing the external vendor relationship. The ideal candidate is confident, articulate, and able to convey information and deliver training presentations to a variety of audiences within Claims and Underwriting. This position reports to the Manager of Claims Technical Services.

Responsibilities

• Receive SIU referrals and investigation assistance requests from internal and external claim staff

• Complete ISO and database searches and document the files accordingly

• Refer assignments to appropriate vendors for proper task completion

• Establish relationships with vendors, Coaction management, internal claim staff, and other industry experts

• Consult with claims handlers for additional investigation opportunities and mitigation of damages

• Oversee vendors and monitor expenses associated with the investigation

• Assist SIU Vendor and Legal department with training of claims staff

• Complete claim reviews on SIU vendor adherence to service level agreements

• Complete claim reviews for claim handler adherence to SIU referral requirements

• Complete social media reviews and determine if formal SIU file review is warranted

• Manage investigative billing and invoice processing

• Populate tracking spreadsheets to follow assignments and analyze impact of services provided

• Develop a creative approach to problem solving

• Assist in identifying potential missed opportunities through file reviews

• Work independently with little supervision and meet aggressive deadlines

• Work as part of a cohesive team within Claims Technical Services and the Claims department

• Attend industry meetings and training, including online training on current industry trends

Qualifications

• 3+ years' experience working in a Claims environment

• Proven experience and expertise in social media and background searches

• Knowledge and understanding of insurance claims

• 4-year college degree or related work experience preferred

• Proficient with MS Office suite, including Excel and PowerPoint

• Keen attention to details

• Excellent time management skills

• Exceptional organizational skills

Equal Opportunity Employer

Coaction is an Equal Employment Opportunity employer. Coaction's policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.