SIU Investigator I

This is a fully remote position, open to applicants in Arizona, +4 more states.

📋 Description

• Examine dubious and questionable claims activities from both first- and third-party sources.

• Utilize knowledge of fraud schemes and investigative techniques.

• Engage in the formulation of fraud prevention measures.

• Conduct investigations related to claims involving P&C insurance products, services, policy agreements, coverages, and claims processing protocols.

• Implement state insurance fraud statutes and regulations.

• Gather evidence through field or remote interviews, investigative databases, internal resources, online resources, public records, and forensic tools.

• Offer recommendations within established authority parameters.

• Create and deliver detailed verbal and written investigative reports.

• Build and sustain relationships with industry contacts, law enforcement, and other stakeholders in fraud investigations.

• Act as a resource team member for specific issues.

• Contribute to fraud awareness training programs.

• Manage CAT duty responsibilities as required by the business.

• Identify, assess, monitor, and mitigate risks linked to business operations.

⛳️ Requirements

• High School Diploma or General Equivalency Diploma.

• Minimum of 2 years of experience in claims adjusting or in P&C SIU/Fraud Investigation.

• At least 4 years of previous investigative experience in law enforcement, including military service, or relevant fraud industry investigation experience as an alternative.

• Demonstrated investigatory capabilities.

• Experience in obtaining statements from involved parties, witnesses, and suspects.

• Proficiency in gathering evidence and forming conclusions from objective details related to fraud.

• Capacity to organize and prioritize tasks, manage multiple responsibilities, and develop solutions.

• Familiarity with computer systems and software utilized for data entry and analysis.

• Understanding of municipal, state, and local regulations.

• Knowledge of legal principles, contracts, case law, medical treatment, and medical terminology.

• SIU experience conducting straightforward to complex P&C fraud investigations, or a blend of claims and law enforcement/military investigative experience.

• Ability to supervise third-party investigative support services.

• Credentials such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, or CCLS are considered advantageous.

• Must not require immigration assistance or visa sponsorship now or in the future.

🏝️ Benefits

• Comprehensive medical, dental, and vision insurance plans.

• 401(k) retirement plan.

• Pension plan.

• Life insurance coverage.

• Parental leave benefits.

• Adoption support.

• Paid time off program.

• Paid holidays.

• 16 hours of paid volunteer time.

• A variety of wellness initiatives.

• Career development planning.

• Opportunities for continuing education.

• Performance-based pay incentives may be available.