SIU Investigator

About the role

CITON is seeking an experienced SIU Investigator to conduct comprehensive investigations into suspicious or potentially fraudulent insurance claims. This role requires strong field investigative experience, analytical skills, and the ability to independently manage complex case assignments across multiple jurisdictions.

Responsibilities

• Conduct detailed, timely, and thorough investigations utilizing established SIU investigative principles
• Perform field and scene investigations, including inspections and evidence documentation
• Obtain recorded statements from insureds, claimants, and witnesses
• Analyze claims, documentation, and data to identify fraud indicators and inconsistencies
• Prepare comprehensive investigative reports and summaries supporting findings
• Conduct or support Examinations Under Oath (EUO) as required
• Ensure compliance with Department of Insurance reporting requirements and anti-fraud regulations
• Collaborate with claims teams, legal counsel, and SIU leadership on complex investigations
• Coordinate with external partners including NICB, law enforcement, IASIU, and investigative vendors
• Provide deposition and courtroom testimony when required
• Maintain accurate documentation and case management tracking
• Participate in fraud awareness training and internal education initiatives
• Attend industry meetings and maintain required anti-fraud continuing education

Qualifications

• Bachelor’s degree preferred or equivalent professional experience
• Minimum 4+ years of SIU, fraud investigation, or investigative law enforcement experience
• Experience handling complex, high-volume investigative caseloads
• Prior military or law enforcement investigative experience considered a strong plus

Core Competencies

• Strong investigative and analytical skillset
• Ability to work independently with minimal direction
• Excellent written and verbal communication skills
• Sound judgment and decision-making ability
• Knowledge of medical terminology and claims-related documentation
• Proficiency with Microsoft Office, investigative tools, open-source intelligence, and Verisk platforms
• Strong relationship-building skills with internal and external stakeholders

Preferred Certifications

• CIFI (Certified Insurance Fraud Investigator)
• CFE (Certified Fraud Examiner)
• FCLS, FCLA or other relevant industry designations

Benefits

Competitive compensation and performance incentives
Medical, dental, vision, 401k, paid holidays, PTO and more!