Mid-Level SIU Life & Health Investigator - Life Claims Investigations Job at USAA, San Antonio, TX

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  • USAA
  • San Antonio, TX

Job Description

Why USAA? Let’s do something that really matters.


At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. We’re working as one to build a great experience and make a real impact for our members.


We believe in our core values of honesty, integrity, loyalty and service. They’re what guides everything we do – from how we treat our members to how we treat each other. Come be a part of what makes us so special! The Opportunity

As a dedicated SIU Life & Health Investigator you will review, analyze and investigate all life, health and waiver of life insurance premium claims to ensure claim validity and legal liability/risk management. You will also provide recommendations on claim settlements and assist with fraud detection and deterrence, consults with Legal and Life Underwriting teams and external medical providers as appropriate, as well as monitor appropriate loss and expense claims reserves.

As a Mid-Level Life SIU Investigator for Life Claims Investigations you will support the Life Special Investigations team that is responsible for increasing fraud awareness throughout USAA and its membership, developing innovative fraud detection and prevention programs, and investigating cases of suspected fraud for Life Company.

This hybrid role requires an individual to be in the office 3 days per week . This position can be based in San Antonio, TX at the Home Office or can work remotely in the continental U.S. with occasional business travel. Relocation assistance is available for this position.

What you'll do:

  • Applies proficient knowledge of life, health and annuity/investment contracts and coverage to ensure appropriate investigation and/or settlement.
  • Proactively manages the life of the investigative case, and acts as the liaison between member and internal legal counsel.
  • Prepares material for cases and adjusts investigative strategies as required, based on case development.
  • Validates, evaluates and negotiates settlement of claims.
  • Gathers supporting documentation to make claim settlement determinations and negotiate claim payments.
  • Represents USAA at mediations, case conferences and/or trial as required.
  • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

  • High School Diploma or General Equivalency Diploma required.
  • 2 years life insurance claims experience or equivalent experience in financial services and/or investigative activities.
  • Proficient knowledge of industry products, services and claims processes and related medical terminology.
  • Proficient knowledge of regulations governing fraudulent activity.
  • Knowledge of Microsoft Office products required.

What sets you apart:

  • 4+ years life insurance claims and/or life claims investigation experience.
  • 2+ years complex life insurance claim experience.
  • CFE, ALHC, or other relevant industry designations.
  • Proficient knowledge and understanding of fraud investigations as well as application of state/federal laws and regulations.
  • Ability to gather a broad range of evidence and draw conclusions based on the objective details.
  • Strong oral and written communication skills.
  • Demonstrated experience analyzing and interpreting data to identify trends and patterns.
  • US military experience through military service or a military spouse/domestic partner

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

What we offer:

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is:$ 51,900.00- $ 83,420.00

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, please visit our benefits page on USAAjobs.com.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Tags

Holiday work, Full time, Remote job, Work from home, Home office, Relocation package, 3 days per week,

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