• SIU Analyst

    Location US-FL-Tampa | US-TX-Richardson | US-NY-Hauppauge | US-AZ-Mesa | US-SC-Greenville | US-WI-Madison | US-GA-Alpharetta | US-CO-Lone Tree | US-CA-Rocklin | US-NJ-Bridgewater | US-SC-Greenville...
    Job ID
    36186
  • Summary

    Esurance is looking for an SIU Analyst to join a dynamic and award-winning team of individuals who are committed to making insurance smarter, easier, and dare we say- cooler. As part of a growing company that is focused on providing an outstanding customer experience, you’ll have the opportunity to expand your skills and discover your potential.

     

    If you’re looking for a career at a socially conscious company that offers great benefits — including matching 401k and tuition reimbursement — then you may have just found your new home. 

     

    Esurance combines the spunk of a startup company with the backing of Allstate (the largest publicly held personal lines insurer in the U.S.) to create a unique, energized, and exciting place to work. 

     

    This position will report out of an office and cannot be fulfilled as WAH.

    Responsibilities

    Analyzes special investigations cases and/or medical billing investigations to develop and assist with cases conducted by the SIU Investigators and Managers or proactive referrals.

    Job Responsibilities:

    • Researches complex projects to include analysis of data with a finished written report for SIU complex case investigations
    • Searches proactive data to locate claims with a probability of suspicious activity using fraud detection software and/or advanced data queries from in house and subscribed data services.
    • May be required to assist with database administration and maintenance of certain fraud analytics databases and platforms. 
    • Strategically mine policy billing data, telephone data and internet transaction data to identify or confirm suspicious trends relating to organized claim fraud and major cases.
    • Complete link analysis studies working towards mastering proficiency needed to complete complex link analysis studies using specialized analytical tools and software packages.
    • Conduct, organize and maintain Medical Major Case investigative and analytical objectives and recommendations. This includes review and oversight of MedAware alerts.
    • Performs quantification of company exposures to subject(s) under investigation.
    • Performs daily database runs to analyze data and report findings to SIU Management and Investigators.
    • Provides training to Claims and SIU regarding outcomes of investigations and company-wide fraud analysis training.
    • Participates in NICB task force projects.
    • May testify in court on case specific to SIU work.

      Qualifications:
    • Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
    • Demonstrated ability to manage relationships with both internal and external customers.
    • Demonstrated ability to work effectively independently and within a collaborative team oriented environment using sound judgment in decision-making.
    • Excellent communication skills both oral and written with strong analytical skills.
    • Demonstrated proficiency with Microsoft Office products (Outlook, Excel, PowerPoint, and Word), claims related software programs (Fraud Modeling software), billing software programs (knowledge of CPT, E/M & ICD-9 codes).
    • Demonstrated ability in data transfer, mining and research techniques.
    • Demonstrated knowledge with secure and process public records via the internet and/or state specific public record and body shop estimating/billing database software programs.
    • Demonstrated knowledge of insurance and medical terminology and knowledge with corporate practice of medicine doctrine, state laws regarding medical treatment delivery, licensing and regulation.

      Experience / Education:
    • Bachelor’s Degree in Business, Insurance, Statistics or related field is preferred. Degree or industry/functional coursework in Criminal Justice, Criminal Behavior, Research Methods, Statistics, Analysis and GIS preferred but not required.
    • Knowledge of i2 Programs preferred (Analyst Notebook and iBase), prior experience with ISO View Link Manager or NetMap software preferred, and experience working with SQL Server queries and databases strongly desired
    • Three to five years of special investigation unit analysis or investigator or equivalent experience preferred
    • Programming knowledge preferred
    • SAS fraud programming experience desired

      Physical Demands and Work Environment: Representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be able to operate a PC and sit for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    Qualifications

    Benefits

    At Esurance, being committed to our employees is not just something we say, it’s something we do. Our benefits package is designed to help our associates stay healthy, meet their long-term financial goals, and balance the demands of work and personal life. Esurance rewards hard work, dedication, and creativity with competitive salaries and a generous bonus system. We are committed to our employees and we are dedicated to creating a diverse, positive, innovative and team-oriented work environment.

    Health & wellness

    • Medical, vision, and dental insurance
    • Life insurance (company-paid and supplemental)
    • Accidental death and dismemberment coverage
    • Wellness coaching and incentives
    • Group critical illness coverage
    • Accident indemnity and hospital indemnity plans
    • Group legal

    Savings

    • 401(k) plan with annual matching contribution
    • Referral bonuses
    • Performance-rewarding bonus system
    • Tuition assistance program (up to $5,250 per year)
    • Health savings and flexible spending accounts
    • Commuter benefits

    Family & Community

    • Adoption assistance
    • Maternity leave
    • Buckle Up Baby program
    • Pet insurance discount
    • Charitable gift matching
    • Give Time, Get Time volunteer program
    • Employee Assistance Program

    Time off

    • Short-term disability
    • Long-term disability (employee-paid option)
    • Paid time off (holidays, vacation, personal choice days)

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