Job Description

We are seeking an experienced SIU Investigator with a proven background conducting complex investigations involving fraud, suspicious activity, and high-risk claims or transactions. This position is intended for seasoned investigators who can work independently, manage cases from inception through resolution, and produce professional investigative findings with minimal supervision.

Candidates without substantial, consistent SIU investigative experience will not be considered.

Key Responsibilities

• Conduct comprehensive investigations involving suspected fraud, misrepresentation, abuse, misconduct, or other suspicious activity. 
• Analyze claims, records, financial documents, surveillance materials, interviews, and other evidence to identify fraud indicators and investigative leads. 
• Prepare thorough, accurate, and defensible investigative reports suitable for internal review, legal proceedings, or regulatory submission. 
• Conduct interviews with claimants, witnesses, vendors, employees, and other involved parties. 
• Coordinate with management, legal counsel, law enforcement, regulatory agencies, and external partners when necessary. 
• Maintain organized and compliant case documentation and evidence files. 
• Identify trends, patterns, and emerging fraud risks and recommend preventative measures. 
• Manage multiple investigations simultaneously while meeting deadlines and quality standards. 
• Exercise sound judgment and maintain strict confidentiality in all investigative matters. 

Required Qualifications

• Minimum 5+ years of direct SIU investigative experience required. 
• Demonstrated experience handling fraud investigations independently from intake through closure. 
• Strong knowledge of investigative procedures, evidence handling, and fraud detection techniques. 
• Excellent report writing and documentation skills. 
• Experience conducting recorded statements and investigative interviews. 
• Ability to analyze complex information and make sound investigative determinations. 
• High attention to detail and strong organizational skills. 
• Professional demeanor with the ability to handle sensitive and confidential matters appropriately. 
• Proficiency with investigative databases, case management systems, and Microsoft Office applications. 

Preferred Qualifications

• Experience in insurance SIU, healthcare fraud, financial crimes, corporate investigations, or related fields. 
• Previous law enforcement or regulatory investigative experience is a plus. 
• CFE (Certified Fraud Examiner) or similar professional certification preferred. 
• Knowledge of applicable state and federal fraud regulations. 

Important Applicant Requirement

This role requires prior hands-on SIU investigative experience. Applicants without verifiable SIU experience, fraud investigation experience, or closely related investigative backgrounds will not be considered.

Work Environment

• Small company environment with a collaborative and fast-paced culture. 
• Ability to work independently with minimal oversight. 
• Remote, hybrid, or field work may be required depending on investigative needs.

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