Having an in-house Special Investigation Unit (SIU) can require significant resources - time, money and manpower. With the high volume of claims to be adjudicated, many businesses opt to focus on high-value claims or those that can be easily resolved.
We provide training for Claims personnel on investigative process, case management and reporting. Our fraud experts have decades of experience in fraud analytics, risk mitigation and providing related business intelligence services.
By building in-house competencies in fraud awareness and investigation training, insurance companies increase their chances of identifying and curbing losses due to fraud. Within the fraud detection hub, member's claims are reviewed by expert fraud analysts and reason codes are provided for each questionable claim to assist the claims processors.