SIU Investigator Resume

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Here is the SIU Investigator Resume example:

Jesse Ferree

497 Turkey Pen Road

New York, NY 10013

(555)-555-5555

[email]

Career Objective To obtain a SIU Investigator position with company seeking dedicated and hard working employee.

Summary of Qualifications:

Remarkable experience in FWA detection, prevention and correction techniques
Profound knowledge of insurance and claim operations, commercial, personal, and Workers Compensation insurance products and litigation management
Skilled in writing, interviewing, strategizing and question formulation and presenting information
Profound knowledge of regulatory issues and case law effecting medical investigations
Sound knowledge of medical terminology, CPT and ICD-9 coding
Exceptional ability to handle heavy workload and meet critical regulatory guidelines
Ability to organize and handle a heavy case load
Excellent oral and written communication skills

Work Experience:

SIU Investigator, August 2005 – Present

Universal American, New York, NY

Developed and prepared internal Fraud Alerts for company-wide distribution.
Communicated through telephone interview with members, pharmacies, providers and third parties.
Conducted and assisted on site audits of pharmacies.
Met all regulatory and departmental deadlines.
Developed and maintained contacts and liaison with law enforcement, regulatory agencies, and task force members.

SIU Investigator, May 2000 – July 2005

Direct Auto Insurance, New York, NY

Recognized suspect issues and prepared an investigative strategy for determining the validity of the claim.
Analyzed and developed leads for the proper verification of facts and circumstances.
Developed and executed investigative Action Plans for all referred claims.
Prepared daily investigative notes and reports in an efficient, cohesive and chronological manner.
Provided evidence and testified in civil and criminal cases related to investigations.

Education

Bachelor’s Degree in Business Administration, Johnson State College, Johnson, VT