Remote) Sr. Special Investigator

Chicago, IL (Remote)
Des Plaines, IL 60018, USA

Fidelity Life is a leading provider of financial security for middle market consumers. With a history of innovation, the company is redefining the life insurance industry with patented products and processes. Fidelity Life pioneered the use of predictive analytics to streamline the new business process and revolutionize the speed that policies can be issued. Established in 1896, Fidelity Life enjoys a long track-record of success and continues to build its reputation of sound fiscal management and customer-focused innovation.

In concert with Fidelity Life, eFinancial is an online and call-center-based insurance agency with a proven direct-to-consumer life insurance model. Using a proprietary and patented sales technology platform, eFinancial’s licensed agents help thousands of consumers each day with their unique life insurance needs – often with just a single phone call. To complement this channel, the company recently expanded to offer an entirely digital purchase experience.

Fidelity Life and eFinancial are part ofiA Financial Group and are revolutionizing the life insurance industry to make protection more accessible and affordable for everyday Americans. With integrated marketing, product manufacturing, and controlled distribution, the enterprise is uniquely positioned to grow.

Case Intake & Triage:

• Review alerts, referrals, and claims for indicators of fraud or suspicious activity, including misrepresentation, forgery, beneficiary fraud, and agent/distributor misconduct.
• Independently prioritize and triage the SIU’s cases based on risk, severity, exposure, regulatory deadlines and reputational risk.
• Establish and maintain accurate, audit-ready case logs and documentation standards in accordance with internal procedures and regulatory guidelines.
• Manage a concurrent caseload of complex, high-value investigations from intake through resolution, often serving as escalation point for cases initiated by other team members.
• Interpersonal and presentation skills to communicate, and represent the SIU, with internal and external sources
• Comfort operating in a small or scaling team, including contributing to process design and program build-out rather than relying solely on existing infrastructure.

Investigation Conduct & Leadership:

• Lead and independently manage end-to-end fraud investigations involving life insurance claims, policy procurement, and distribution channel activity, including multi-jurisdictional or organized fraud schemes.
• Serve as lead case strategist on all of SIU's complex investigations, coordinating cross-functional response among claims, compliance, underwriting, and legal as well as external investigators or vendors
• Plan and conduct structured interviews of claimants, agents, witnesses, and other relevant parties, including high-stakes or adversarial interviews requiring advanced interviewing strategy.
• Gather, organize, and critically analyze evidence sets including claim records, policy files, medical records, financial statements, public records, and third-party data sources.
• Compile and organize investigative exhibits, evidence packages, and case files suitable for internal review, civil referral, criminal referral, or regulatory submission.
• Draft clear, concise, and well-supported fraud case summaries and investigative reports for SIU leadership, legal counsel, and compliance teams as well as reports to state departments of insurance and national fraud databases within required time frames.
• Help define investigative standards, case documentation templates, and onboarding practices.

Regulatory Compliance:

• Ensure all SIU activities are conducted in accordance with state and federal insurance fraud regulations.
• Lead preparations and submission of mandatory fraud reports to state departments of insurance and national fraud databases (e.g., NICB).
• Maintain documentation for audits and regulatory reviews.
• Monitor and interpret regulatory changes, emerging fraud schemes, and industry trends, translating implications into updated investigative practice for the team

Data & Reporting:

• Apply advanced data mining…