SIU Investigator II

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

📋 Description

• Investigate and assess moderately complex referrals from the Special Investigation Unit, including cases of suspected organized fraud.

• Review claims, underwriting details, premium audits, public records, claims history, and social media information.

• Conduct interviews, gather statements, execute field investigations, and analyze supporting documentation.

• Attend examinations under oath and depositions as necessary.

• Collaborate with internal teams, legal counsel, law enforcement, and other pertinent stakeholders.

• Analyze evidence to either support or dismiss allegations of fraud.

• Provide recommendations for appropriate claim or policy management.

• Seek recovery or restitution opportunities when applicable.

• Prepare investigative reports, state-required anti-fraud documentation, and evidence packages for civil litigation or criminal prosecution.

• Communicate the status of investigations, findings, and recommendations to relevant stakeholders.

• Assist in the development and delivery of internal anti-fraud training programs.

• Promote awareness of SIU services within the organization.

• Contribute to the formulation of investigative policies, practices, and procedures.

• Maintain active participation in relevant professional associations.

⛳️ Requirements

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

• A minimum of three years of experience in claims adjusting, investigation, or insurance-related roles.

• Prior experience in property and casualty insurance is preferred.

• Obtain a Fraud Claim Law Specialist designation within the first year of employment.

• Insurance designations such as INS, AIC, and FCLS are preferred.

• Strong understanding of the investigative process, including the proper identification and collection of physical evidence.

• Solid knowledge of civil and criminal investigative procedures as well as the legal system.

• Familiarity with statement-taking techniques and the collection and analysis of both public and private records.

• Preferred knowledge of the property and casualty insurance industry and fraud awareness.

• Excellent investigative skills and sound decision-making capabilities.

• Proficient in conflict resolution, negotiation, and facilitation.

• Ability to work independently as well as collaboratively within a team.

• Strong verbal and written communication skills, including proficiency in file documentation and report writing.

• Good computer skills and proficiency in the Microsoft Office Suite.

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

• Willingness to travel occasionally.

• A valid driver’s license with an acceptable motor vehicle report per company standards is required for driving purposes.

🏝️ Benefits

• Comprehensive rewards package; details on benefits can be found at www.emcins.com/careers.

• Flexible work-from-home options available.

• Work environments and company vehicles are tobacco-free.