Senior Investigator – Special Investigations Unit, Illinois, Indiana, Michigan

• Investigate suspected insurance fraud involving auto, property, casualty, workers' compensation, and other personal, commercial, and specialty lines of business.
• Work independently and collaboratively with internal stakeholders and external partners to evaluate and investigate suspicious insurance transactions (claims, underwriting, policy, etc.), collect evidence, support fraud detection programs, and communicate investigative findings to internal and external partners, regulators, and law enforcement.
• Support fraud detection and investigation by identifying red flags, gathering facts, and documenting evidence in compliance with company policy and legal requirements.
• Review claim files for basic red flags (inconsistencies, late reporting, coverage anomalies, questionable damages, medical billing issues).
• Conduct and lead thorough investigations of suspect, high exposure, and complex insurance claims and underwriting/policy concerns, including personal, commercial, and specialty lines of business - including property, auto, workers compensation, and other coverage types.
• Prepare detailed investigative reports for internal decision-making; support referrals to law enforcement or legal action when necessary, and where applicable to state fraud bureaus.
• Maintain thorough documentation of investigative actions and work product in accordance with accepted SIU operating standards and best practices.

• 8-10 years of fraud investigation, claims investigation, SIU support, or related research/analyst experience or equivalent combination of education and experience.
• Advanced insurance fraud investigative skills including evidence gathering and interviewing with demonstrated ability to follow investigative processes and best practices are essential
• Clear written and verbal communication skills, including the ability to summarize complex findings; collaborative mindset and commitment to continuous learning as tools, regulations, and fraud tactics evolve.
• Proficient in investigative databases and standard office software.
• Ability to proficiently use computers and software for data entry, digital tools for research, and investigative analysis; digital photo/video documentation of loss scenes and evidence.
• Ability to work effectively with AI-enabled investigative tools (e.g., fraud scoring)

Demonstrates advanced investigative skills in insurance fraud, including evidence gathering, interviewing, and compliance with legal requirements. Proficient in using investigative databases and digital tools for analysis and documentation.

• Fraud Investigation
• Evidence Gathering
• Claims Investigation
• Investigative Reporting
• Collaborative Communication

• Insurance Fraud Investigation
• Evidence Documentation
• Claims Analysis
• Interviewing Techniques
• Investigative Processes
• Data Entry
• Digital Documentation
• Fraud Detection Programs
• Regulatory Compliance
• Analytical Research

• Clear Communication
• Collaborative Mindset
• Continuous Learning

• Insurance Fraud
• SIU Support
• Personal Lines
• Commercial Lines
• Specialty Lines
• Property Insurance
• Auto Insurance
• Workers Compensation
• Fraud Scoring
• Regulators

• Investigative Databases
• Standard Office Software
• AI-Enabled Investigative Tools
• Digital Photo/Video Documentation