- Salary
- $65k – $82k/yr
- Location
- Home, Alabama
- Workplace
- Remote
- Type
- Full-time
- Seniority
- Mid
- Source
- Pinpoint
Description
Special Investigations Unit Investigator (Remote)
Department: Risk Management and Loss Control
Employment Type: Permanent - Full Time
Location: Home United States
Reporting To: Director of SIU
Compensation: $65,000 - $82,000 / year
Description
What's in Store
We are on the lookout for an experienced Special Investigations Unit (SIU) Investigator to join our team! You will be responsible for conducting comprehensive investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity.
Key Responsibilities
- Conduct comprehensive SIU investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity.
- Investigate insurance claims by researching claimant activity, employment history, business interests, prior claims, relationships, and other relevant areas of inquiry.
- Conduct detailed background investigations using public records, proprietary databases, court records, business records, social media, and other approved investigative resources.
- Handle investigations across multiple lines of business, including Workers’ Compensation, General Liability, Auto, Property, and other insurance-related matters.
- Review claim files, SIU referrals, supporting documentation, and available evidence to develop effective investigative strategies and appropriate next steps.
- Identify investigative leads, inconsistencies, fraud indicators, and opportunities for additional investigative activity.
- Conduct interviews and obtain recorded or written statements, as appropriate.
- Coordinate investigative activities with claims professionals, SIU leadership, clients, attorneys, and other stakeholders as needed.
- Prepare clear, accurate, timely, and professional investigative reports documenting findings, evidence, activities performed, and recommended next steps.
- Maintain accurate case documentation and ensure investigations are completed in accordance with applicable regulations, client requirements, and internal procedures.
- Manage assigned caseload effectively while meeting established quality standards, deadlines, and service expectations.
- Maintain confidentiality and appropriately handle sensitive claim and investigative information.
Skills, knowledge & expertise
- Workers’ Compensation investigative experience is required.
- Prior experience conducting SIU, insurance fraud, claims, law enforcement, corporate, or related investigations.
- Demonstrated experience conducting background investigations and researching public records and investigative databases.
- Strong interviewing, investigative research, analytical, and report-writing skills.
- Ability to analyze claim documentation and recognize inconsistencies, suspicious activity, and potential fraud indicators.
- Strong organizational and time-management skills with the ability to manage multiple investigations simultaneously.
- Excellent written and verbal communication skills.
- Ability to work independently in a remote environment while collaborating effectively with internal teams and clients.
- Proficiency with Microsoft Office and familiarity with claims management, investigative research, or case management systems.
- Investigative experience across multiple insurance lines, particularly Workers’ Compensation, General Liability, Auto, and Property.
- Previous experience working within an insurance carrier, third-party administrator (TPA), SIU, investigative firm, or law enforcement environment.
- Experience conducting field investigations, interviews, statements, background investigations, and social media or open-source research.
- Experience with Premium Fraud investigations.
- Familiarity with insurance fraud regulations and SIU compliance requirements.
- Candidates located in Southern California or Central Florida are strongly preferred.
Equal Employment Opportunity & Legal Notices
- Medical, dental, and vision plans to support your health and that of your family
- A 401(k) plan with employer matching
- Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
- Paid holidays
- Life insurance and short‑term and long‑term disability coverage
Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.
- Maintain regular and dependable attendance.
- Be available and able to perform job responsibilities during established work hours.
Massachusetts Notice
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
AI Policy
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