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Claims Analyst – Special Investigations Unit

Arch Insurance Group Inc.

This is a Contract position in Lexington, KY posted May 7, 2022.

The Position: WORK HERE.


THRIVE HEREAt Arch, our goal is to provide talented people a foundation where their skills are best used.

Our diversified platform means there are a variety of opportunities to deploy your skill sets.From our point of view, a range of experience (not strictly in insurance) helps us advance a democracy of ideas that makes us a better, more thoughtful company.We are recognized as a thought leader in the insurance industry, and we are a growing, dynamic organization that works to provide strategic solutions for our clients.We embrace the collaboration necessary to innovate in todays evolving marketplace; encourage participation and diversity of thought; and rely on talented, innovative individuals in all of the areas that are crucial to our success.The Claims Division is currently recruiting for an Special Investigations Analyst to join our Special Investigations Unit (SIU).

This individual must have investigative skills to independently conduct aspects of fraud review, anti-fraud compliance audits as well as other insurance related investigations.Under technical direction, outline a game plan for assignment objectives and appropriately document and communicate to clients and the SIU Director.

Works within specific limits of authority on assignments requiring moderate technical complexity and coordination.

Utilizing SIU guidelines and policies, reviews referrals to ensure proper documentation received, determines if an investigation will be pursued and handle to resolution.

Job Responsibilities: Specific duties include but not limited to the below:Complete proper ISO searches to summarize and make recommendations on loss historyDetermine if tasks can be completed internally or require the use of a vendor and make the referral if warranted.

These referrals include background checks, surveillance, and AOE/COE investigative assignmentsBecome aware of the best vendor to use for a given circumstance or jurisdictionComplete State Fraud Referral request forms with all required data for the specified jurisdiction including: claim summary, red flag indicators, investigation summaries, all parties involved, litigation summary and claim status or dispositionNavigate through several different TPA/MGA claim systems to retrieve information for ISO searches, SFRs, case referrals to vendors and to obtain claim and policy informationAssist SIU Director with projects, reconciliations, writing audit result reports and handling routine/daily matters in their absenceTriage incoming new referrals to SIU to set objectives and determine if internal handling or vendor utilization is necessaryBuild relationships with SIU vendors and determine which are most effective in results and cost Required Skills/Experience: Minimum of one to three years’ claims experience, prior specail investigations experience is desirableSolid knowledge of claims and insurance theory and practicesDemonstrated technical expertise, product specific knowledge, and negotiation skillsStrong interpersonal and communication skillsAbility to effectively interact with all levels of Archs internal and external business partnersAbility to work independentlyStrong analytical and problem-solving skillsKnowledge of Microsoft Office Suite as well as other business-related software Education: Bachelor’s degree or equivalent experience, professional designations preferred The Company: Arch Insurance is a global insurer offering our clients superior coverage and service.

We embody the Arch guiding principle of focusing on retaining experienced and talented employees to differentiate us from the rest of the pack.

Our group operates from offices in the US, Canada, Bermuda, UK, and Australia, providing specialty risk solutions to clients worldwide across a wide range of industries.With nearly 20 years of operating history and strong financial ratings, our track record remains solid.Arch Insurance employs a disciplined underwriting approach and prudent risk selection across all types of business.

Our mission is to provide our insureds with superb coverage and claims handling through careful and diligent underwriting of risks and business-friendly solutions.

Across our global operations, Arch Insurance employees are ready to meet your needs with professionalism and excellence.LI-REMOTELI-MJ1