Senior Investigator

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Conduct investigations and assessments of moderate to high-complexity SIU referrals, including organized ring activities.

• Analyze claims, underwriting, premium audits, billing, invoices, receipts, and other relevant documentation.

• Reach out to various departments, insured individuals, claimants, witnesses, vendors, carriers, attorneys, law enforcement, and other relevant parties to gather information.

• Investigate public records, claims history, social media, and other background data.

• Collect statements and perform field investigations.

• Record investigative actions, activities, evidence, and findings.

• Participate in examinations under oath and depositions.

• Monitor trends in investigations and organized ring activities.

• Provide status updates to internal teams, agents, defense counsel, and law enforcement agencies.

• Identify, investigate, and pursue opportunities for recovery or restitution.

• Analyze investigative data and evidence, recommending actions regarding claims or policy handling, including payment, compromise, denial, or rescission.

• Prepare special reports, evidence compilations, anti-fraud reports, and documentation for litigation or prosecution.

• Communicate investigative efforts and evidence that support or exonerate potential fraud cases.

• Create and deliver internal and external anti-fraud training sessions and educational resources.

• Collaborate on SIU marketing initiatives and execute assigned strategies.

• Assist in the development of SIU investigation policies, standards, practices, techniques, and procedures.

• Remain actively engaged in relevant professional organizations.

⛳️ Requirements

• A Bachelor’s degree in business, insurance, criminal justice, or a related field, or equivalent relevant experience.

• A minimum of five years of experience in claims adjusting, investigation, or insurance, or related fields.

• Prior experience in property and casualty insurance is preferred.

• Acquire the Fraud Claim Law Specialist (FCLS) designation within the first year of employment.

• Insurance designations such as INS or AIC are preferred.

• Strong understanding of investigative processes, collection of physical evidence, civil and criminal investigative procedures, legal systems, statement-taking methods, and public/private records.

• Familiarity with the property and casualty insurance sector and awareness of fraud is preferred.

• Excellent investigative, decision-making, conflict resolution, negotiation, facilitation, and both verbal and written communication skills.

• Capable of working independently as well as collaboratively within a team.

• Proficient with computers and the Microsoft Office Suite.

• Attend the National Insurance Crime Bureau SIU Academy within the first two years of employment.

• Willingness to travel occasionally.

• A valid driver’s license with a satisfactory motor vehicle report as per company standards is required if driving.

🏝️ Benefits

• A comprehensive rewards package; details regarding benefits can be found at www.emcins.com/careers.

• Opportunity to work remotely from anywhere in the United States.

• Professional designation opportunity: Fraud Claim Law Specialist (FCLS) within the first year of employment.

• Attendance at the National Insurance Crime Bureau SIU Academy within the first two years of employment.