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SIU Employment Opportunities

Liberty Mutual Major Case Special Investigations U...
Author Last Post
Job ID: 98499
Job Location: Plano, Texas

Advance your career at Liberty Mutual - A Fortune 100 Company!

Are you looking for an exciting investigative opportunity with a leading insurance carrier? Liberty Mutual Insurance is looking for an individual to join our Special Investigations Unit in State. The ideal candidate will be tasked with conducting detailed investigations into suspicious organized activity and providers.You will handle complex cases with moderate supervision.

The territory for this position is Plano, TX.

Responsibilities:


•Conduct extensive and detailed investigations of suspected organized activity and suspicious medical practices
•Develop and execute comprehensive investigative action plans to direct complex investigations and to provide meaningful direction and assistance to outside investigators, legal and claims personnel
•Driven to exceed responsiveness, quality, and other service standards
•Lead in-depth interviews of participants, witnesses or claimants
•Conduct claims file reviews for the purposes of identifying indicators of suspicious patterns and activity in claims
•Oversight of vendors assigned to assist on claims
•Work with outside experts to determine accuracy of alleged facts
•Prepare investigative reports, and PowerPoint presentations for internal review
•Make proper referrals to fraud bureaus and law enforcement
•Assist State and Federal agencies with the prosecution of insurance crimes
•Provide fraud awareness and investigative skills training to branch offices
•Complete annual fraud reports in accordance with state regulations
•Responsible for completing clinic inspections, interviewing clinic providers and employees of those clinics
•Keep abreast of the latest legislation and court decisions on matters pertaining to the investigation of suspicious claims and criminal and civil remedies available for prosecution and restitution.

Preference will be given for those with:

•Familiarity with State jurisdictional requirements
•Proven track record of established relationships with various industry and law enforcement agencies focused on complex investigations.
•Medical and/or Coding knowledge with an emphasis on CPT/ICD codes
•Managing complex files through litigation
•Fluid in Microsoft Office ( PowerPoint, One Note, and Excel)
•Bilingual is preferred

Qualifications:

•Bachelor’s degree with at least five years of law enforcement, claims investigation or analytical background, or ten years of combined field related experience.
•Strong interpersonal, analytical and negotiation skills
•Demonstrated track record with focus on customer service
•Ability to learn quickly and work independently
•Critical thinker with strong desire for continuous improvement
•Strongly Independent, Self-starter.

Benefits:

We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: https://lmi.co/Benefits

Overview:

At Liberty Mutual, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense of humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.

We’re dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Liberty Mutual.
Job: Claims
Primary Location: United States-Texas-Plano
Schedule: Full-time
Salary: $66,600-$94,000
Education Level: Bachelor's Degree (±16 years)

Applicants may apply here: 
https://lmig.taleo.net/careersection/lmigcorp/jobdetail.ftl?job=98499



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