Senior Special Investigator

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

📋 Description

• Analyze alerts, referrals, and claims to identify indicators of fraud or suspicious behavior, including misrepresentation, forgery, beneficiary fraud, and agent/distributor misconduct.

• Effectively prioritize and triage the SIU’s cases based on risk assessment, severity, exposure, regulatory timelines, and reputational implications.

• Create and uphold precise, audit-ready case logs and documentation standards in line with internal procedures and regulatory requirements.

• Oversee a concurrent caseload of intricate, high-value investigations from initiation to resolution.

• Lead and autonomously manage comprehensive fraud investigations related to life insurance claims, policy procurement, and distribution channel activities.

• Organize and execute structured interviews with claimants, agents, witnesses, and other pertinent individuals.

• Collect, categorize, and critically evaluate evidence sets, including claim records and policy documentation.

• Compose clear, concise, and well-substantiated fraud case summaries and investigative reports for SIU leadership and legal advisors.

⛳️ Requirements

• Bachelor’s degree in Criminal Justice, Business, Insurance, or a relevant discipline.

• 5-8 years of experience in insurance claims, fraud investigations, insurance auditing, or compliance (preferably in life insurance), with a minimum of 5 years of investigative experience.

• Proven knowledge of life insurance products, policy structures, claims adjudication processes, fraud typologies, and investigative techniques specific to life insurance.

• Demonstrated capability to independently plan and conduct structured investigative interviews, including complex or adversarial discussions, showcasing strong written communication skills and a history of producing investigative reports and case summaries for regulatory or legal use.

• Proven ability to handle multiple concurrent investigations of complex nature with minimal supervision.

• Competence in interpreting life insurance policy documents and analyzing policy lifecycle activities, transactions, and claims data across various systems to pinpoint inconsistencies, anomalies, or signs of fraud.

🏝️ Benefits

• Medical Insurance: Choose from a variety of plans to fit your healthcare needs.

• Dental Insurance: Coverage for preventive, basic, and major dental services.

• Employer-Paid Vision: Comprehensive eye care coverage at no cost to you.

• Employer-Paid Basic Life and AD&D Insurance: Peace of mind and additional protection.

• Employer-Paid Short-Term and Long-Term Disability Insurance: Financial support in case of illness or injury.

• 401(k) Plan: Save for your future with a company match to help you grow your retirement savings.

• PTO and Sick Time accrue each pay period: Take time off when you need it.

• Annual Bonus Program: Performance-based bonus to reward your hard work.