Job details
Job type full-time
Full job description
Headquartered in the central florida city of lakeland, summit employs over 700 office and field associates at its main location and regional offices in baton rouge, louisiana, and gainesville, georgiaAs the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.
Summit provides workers’ compensation programs and services to thousands of employers throughout the southeast.
Summit is a member of great american insurance group, a company that focuses on building relationships and linking people to various career pathsWhether it’s underwriting, claims, accounting, it, legal, or customer service, great american insurance group combines a small-company entrepreneurial atmosphere with big- company expertise.
Essential job functions and responsibilities
Handles field investigations or assigns field work (i.e Recorded statements, customer service contacts, etc.) to independent investigation firms.
Prepares investigation reports and detailed comprehensive reportsEvaluates claims and recommends courses of action to management.
Adjudicates claims & ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed.
Secures necessary information (i.e., reports, policies, appraisals, releases, statements or other documents) to assist in the investigation of claims.
Identifies trends and patterns of suspected fraudulent activity.
May provide evidence and / or testify in cases where law enforcement agencies pursue prosecution.
May provide guidance to less experienced staff and serve as a resource to other functional areas.
Performs basic searches and prepares basic reports, utilizing databases and technology that support investigations:
May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.
Performs other duties as assigned.
Job requirements
Education: bachelor’s degree or equivalent experience.
Field of study: criminal justice, liberal arts, business, computer science or a related discipline.
Experience: 6 to 10 years of related experience, including criminal investigation or fraud detection experienceProfessional designation (i.e., certified fraud examiner, private investigator license, etc.) from a recognized national investigation organization or state agency preferred.
Must reside in the territory
Company:
Sci summit consulting, llc
Number of positions:
1
