SIU Investigator

Accountabilities

• Conduct thorough investigations of potentially fraudulent claims, analyze evidence, and support accurate claim resolutions through strong investigative practices.
• Review claim files, analyze documentation, and summarize findings clearly within claim management systems.
• Conduct interviews with claimants, witnesses, and relevant parties to gather accurate information and support investigations.
• Perform background research, scene investigations, inspections, surveillance activities, and social media reviews when appropriate.
• Validate information obtained during investigations and pursue additional leads to determine claim accuracy.
• Evaluate investigation results to determine whether fraud can be substantiated and whether further action is required.
• Review fraud-related outcomes and confirm whether claim decisions, including potential denials, are supported by evidence.
• Collaborate with claims professionals, vendors, and internal teams to resolve complex cases.
• Manage vendor relationships and monitor external partner performance during investigative activities.
• Maintain detailed investigation records, update case systems, and communicate outcomes effectively.
• Pursue restitution opportunities when appropriate and return non-fraud cases for continued claims handling.

Requirements

• Experience in insurance claims, investigations, fraud detection, or a related field.
• Strong preference for candidates with auto claims experience and experience managing claims throughout the full claim lifecycle.
• Ability to analyze complex information, identify inconsistencies, and connect details across multiple sources.
• Strong critical thinking and problem-solving skills with the ability to make sound decisions.
• Experience conducting interviews, reviewing documentation, and gathering evidence.
• Strong organizational skills with the ability to manage multiple investigations and priorities.
• Excellent written and verbal communication skills for documenting findings and collaborating with stakeholders.
• Attention to detail and ability to maintain accurate investigation records.
• Ability to work independently while effectively partnering with internal teams and external vendors.
• Knowledge of insurance claims processes, fraud indicators, and investigative best practices is preferred.

Benefits

• Annual salary ranges based on experience and qualifications.
• Potential additional compensation components, including incentive pay or bonuses where applicable.
• Fully remote work opportunity.
• Comprehensive technology setup, including laptop, monitors, headset, keyboard, and mouse.
• Monthly connectivity reimbursement for eligible remote employees.
• Opportunity to develop investigative expertise and contribute to meaningful fraud prevention initiatives.
• Collaborative environment focused on innovation, accuracy, and customer protection.